Methods and compositions for changing the composition of the skin microbiome using complex mixtures of bacterial strains

ABSTRACT

Aspects of the invention relate to compositions comprising one or more live bacterial strains for topical administration to the skin, wherein the one or more live bacterial strains are  Propionibacterium acnes  ( P. acnes ) bacterial strains, and methods for use.

RELATED APPLICATIONS

This application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Application Ser. No. 62/150,225, filed on Apr. 20, 2015, entitled “METHODS AND COMPOSITIONS FOR CHANGING THE COMPOSITION OF THE SKIN MICROBIOME USING COMPLEX MIXTURES OF BACTERIAL STRAINS” and U.S. Provisional Application Ser. No. 62/216,258, filed on Sep. 9, 2015, entitled “METHODS AND COMPOSITIONS FOR CHANGING THE COMPOSITION OF THE SKIN MICROBIOME USING COMPLEX MIXTURES OF BACTERIAL STRAINS,” the entire disclosure of each of which is incorporated by reference herein in its entirety.

FIELD OF INVENTION

The invention relates to methods and compositions for modifying the skin microbiome.

BACKGROUND OF INVENTION

The human body is host to a highly complex and rich microbial community. These microorganisms are generally harmless and contribute to a healthy state by producing vitamins, cooperating with digesting food, or stimulating the immune system. The human microbiota mainly resides on the surface and in deep layers of skin, in the saliva and oral mucosa, in the conjunctiva, and in the gastrointestinal tracts.

It has been demonstrated, primarily in the gut, that human microbiota have fundamental roles in human health and disease. The skin is colonized by a large number of microorganisms, most of them are beneficial or harmless. However, the skin microbiome has specific compositions in diseases states of skin that are different compared to healthy skin. Diseases such as acne vulgaris are associated with strong alterations of the microbiome.

SUMMARY OF INVENTION

Aspects of the invention relate to a method for treating acne, comprising topically administering a disinfectant or antibiotic to the skin of a subject with acne; and topically administering a composition comprising one or more live bacterial strains to the skin of the subject following administration of the disinfectant or antibiotic, wherein the one or more live bacterial strains are P. acnes bacterial strains.

Further aspects of the invention relate to a method comprising topically administering a composition comprising one or more live bacterial strains to the skin of a subject, wherein the one or more live bacterial strains are P. acnes bacterial strains.

In some embodiments, the method is a method for maintaining healthy skin, modulating the skin microbiome of a subject, treating acne, preventing acne, modifying the sebum production of sebaceous glands of a subject, delivering trans-10, cis-12 linoleic acid to the cells of the sebaceous glands or hair follicles of a subject, modifying the bacterial density on the skin of a subject, and/or modifying the ratio of select bacterial species relative to other bacterial species or relative to other microorganisms on the skin of a subject.

In some embodiments, the composition is administered to the skin of a subject following administration of a standard acne treatment. In some embodiments, the standard acne treatment comprises administration of an antibiotic or disinfectant. In some embodiments, the composition is in the form of a gel, cream, ointment, lotion, serum, powder, aerosol spray or two-component dispensing system. In some embodiments, the composition further comprises one or more of a buffer, thickener or carrier.

In some embodiments, the composition comprises 2, 3, 4, 5, 6, 7, 8, 9, 10 or more than 10 different P. acnes bacterial strains. In some embodiments, the composition comprises the P. acnes 6609 (H1) bacterial strain and/or the P. acnes C1 bacterial strain.

In some embodiments, the composition is stable at room temperature for at least three months. In some embodiments, the composition is not naturally occurring. In some embodiments, one or more of the P. acnes bacterial strains is selected from the group of non-pathogenic P. acnes strains consisting of: D1, A5, C3, H1, H2, H3, K1, K2, K4, K6, K8, K9, L1 and F4.

In some embodiments, the composition further comprises one or more of an antibiotic, a disinfectant or salicylic acid. In some embodiments, the composition further comprises an S. epidermidis bacterial strain that inhibits or reduces the growth of other bacterial strains. In some embodiments, one or more of the P. acnes bacterial strains is resistant to the antibiotic or disinfectant. In some embodiments, the composition further comprises peptone.

In some embodiments, the subject is a human. In some embodiments, one or more of the live bacterial strains are components of the skin microbiome. In some embodiments, one or more of the P. acnes bacterial strains within the composition produces low or negligible levels of trans-10, cis-12 linoleic acid. In some embodiments, one or more of the P. acnes bacterial strains within the composition is non-pathogenic, as demonstrated by exhibiting a slow or negligible conversion or degradation of cis-9, cis-12 linoleic acid in media.

Aspects of the invention relate to the use of a composition comprising one or more live bacterial strains for treatment of acne, wherein the composition is topically administered to the skin of a subject with acne following administration of a disinfectant or antibiotic to the skin of the subject, wherein the one or more live bacterial strains are P. acnes bacterial strains, and optionally wherein one or more of the live bacterial strains are selected from the group consisting of: P. acnes 6609 (H1), C1, C3, D1, A5, H1, H2, H3, K1, K2, K4, K6, K8, K9, L1 and F4 bacterial strains.

Further aspects of the invention relate to a composition comprising one or more live bacterial strains for topical administration to the skin, wherein the one or more live bacterial strains are P. acnes bacterial strains.

Further aspects of the invention relate to cosmetic compositions comprising one or more live bacterial strains for topical administration to the skin, wherein the one or more live bacterial strains are P. acnes bacterial strains.

Further aspects of the invention relate to pharmaceutical compositions comprising one or more live bacterial strains for topical administration to the skin, wherein the one or more live bacterial strains are P. acnes bacterial strains.

In some embodiments, the composition is in the form of a gel, cream, ointment, lotion, serum, powder, aerosol spray or two-component dispensing system. In some embodiments, the composition further comprises one or more of a buffer, thickener or carrier.

In some embodiments, the composition comprises 2, 3, 4, 5, 6.7, 8, 9, 10 or more than 10 different P. acnes bacterial strains. In some embodiments, the composition comprises the P. acnes 6609 (H1) bacterial strain and/or the P. acnes C1 bacterial strain. In some embodiments, the composition is stable at room temperature for at least thre months.

In some embodiments, the composition is for treating or preventing acne. In some embodiments, the composition is for maintaining healthy skin. In some embodiments, the composition is not naturally occurring.

In some embodiments, one or more of the P. acnes bacterial strains is selected from the group of non-pathogenic strains consisting of: D1, A5, C3, H1, H2, H3, K1, K2, K4, K6, K8, K9, L1 and F4. In some embodiments, the composition further comprises one or more of an antibiotic, a disinfectant or salicylic acid.

In some embodiments, the composition further comprises an S. epidermidis bacterial strain that inhibits or reduces the growth of other bacterial strains. In some embodiments, one or more of the P. acnes bacterial strains is resistant to the antibiotic or disinfectant.

In some embodiments, the composition further comprises peptone. In some embodiments, the one or more live bacterial strains are components of the skin microbiome. In some embodiments, one or more of the P. acnes bacterial strains within the composition produces low or negligible levels of trans-10, cis-12 linoleic acid, optionally wherein all of the P. acnes bacterial strains within the composition produce low or negligible levels of trans-10, cis-12 linoleic acid.

In some embodiments, one or more of the P. acnes bacterial strains within the composition is selected based on: its ability to produce trans-10, cis-12 linoleic acid; the amount of trans-10, cis-12 linoleic acid it produces in natural environment; the maximum concentration of trans-10, cis-12 linoleic acid it produces; and/or the activity of the enzyme linoleic acid isomerase it produces.

In some embodiments, one or more of the P. acnes bacterial strains within the composition is selected based on its rate of conversion or degradation of cis-9, cis-12 linoleic acid in media. In some embodiments, one or more of the P. acnes bacterial strains within the composition exhibits a slow or negligible conversion or degradation of cis-9, cis-12 linoleic acid in media.

In some embodiments, the method comprises administering a composition described herein to a subject. In some embodiments, the subject is a human.

Aspects of the invention relate to a method comprises obtaining one or more live bacterial strains from the skin of a donor subject, wherein the live bacterial strains are P. acnes strains, determining whether the one or more live bacterial strains are pathogenic, and administering the one or more live bacterial strains to the skin of a recipient subject in need thereof following administration of a disinfectant or antibiotic to the skin of the subject if the one or more live bacterial strains are not pathogenic.

In some embodiments, the donor subject and recipient subject are different. In some embodiments, the donor subject and recipient subject are the same. In some embodiments, an assay is performed to determine whether the live bacterial strain is pathogenic. In some embodiments, the assay comprises assessing the ability of the live bacterial strain to convert or degrade cis-9, cis-12 linoleic acid.

Each of the limitations of the invention can encompass various embodiments of the invention. It is, therefore, anticipated that each of the limitations of the invention involving any one element or combinations of elements can be included in each aspect of the invention. This invention is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The invention is capable of other embodiments and of being practiced or of being carried out in various ways.

BRIEF DESCRIPTION OF DRAWINGS

The accompanying drawings are not intended to be drawn to scale. In the drawings, each identical or nearly identical component that is illustrated in various figures is represented by a like numeral. For purposes of clarity, not every component may be labeled in every drawing. In the drawings:

FIG. 1 is a schematic representation of activity of a composition comprising one or more live bacteria as described herein in combination with a standard antibiotic or disinfectant treatment. The composition comprising one or more live bacteria establishes a healthy microbiome on the skin following treatment of the skin with an antibiotic or disinfectant treatment.

FIG. 2 depicts a microbiome transplantation. A sample of a donor subject's microbiome was cultivated and expanded in the laboratory. Then, the bacterial culture was transplanted onto the previously sterilized skin of a recipient (acceptor) subject.

FIGS. 3A-3D depict microbiome change after transplantation. FIG. 3A shows a heat map displaying the relative abundance of 16S repertoire after transplantation. After several days of application, the recipient subject's 16S profile became closer to the donor subject's 16S profile. FIG. 3B shows that P. acnes strains transferred from donor to recipient. In the upper panel, the bar chart indicates how some P. acnes strains populated the skin of the recipient. In the lower panel, a phylogenetic tree of the strains analyzed is shown (based on Single Locus Sequence Typing (SLST) alleles). FIG. 3C shows a detailed population of the different P. acnes strains in the donor and recipient. FIG. 3D shows that a recipient subject's microbiome became more similar to the donor subject's microbiome after 3 days of application. Spearman correlation was used to measure the distance between different microbiomes.

FIG. 4 depicts a flow chart identifying the current model for the onset of acne. While multiple events are known to be involved, knowledge of connections between the events is missing. The initial trigger of the inflammation has not yet been identified.

FIG. 5 depicts a proposed model for the onset of acne vulgaris, with trans-10, cis-12 linoleic acid produced by P. acnes as a connector between the different events in acne. Black boxes with white text indicate knowledge from acne research; dark gray boxes with white text indicate knowledge obtained from research on trans-10, cis-12 linoleic acid as food supplement; light gray boxes with gray text indicate knowledge in the art; and the three light gray arrows with black outlining indicate new connections disclosed herein, which allow for unification of the existing acne models. First a positive feedback loop between P. acnes colonization and increased production of sebum is established. Further the ER-stress induced by trans-10, cis-12 linoleic acid in proliferating cells and the subsequent apoptosis explains the initial triggering of the inflammation reaction. After the end of puberty, there is less proliferation in the sebaceous glands and the effect of trans-10, cis-12 linoleic acid is limited to the increase of sebum production.

FIG. 6 depicts stability of hydrated P. acnes strain (H1) using various additives and conditions over 47 days. The most stable bacterial composition (stable counts of colony forming units (CFU)) include peptone and are stored at room temperature (RT). Other variations of bacterial compositions included water (H₂O) and PBS and were stored either at room temperature or at 4° C.

FIG. 7 depicts temperature fluctuations during the stability test. Samples marked as RT (room temperature) were stored in ambient temperature that varied during the test. Elevated temperatures are used in stability tests to predict long-term stability. If a product is stable at 45° C. for three months, then it is expected to be stable at room temperature for two years.

FIG. 8 depicts a minimum inhibitory concentration test where three different P. acnes strains were tested in combination with four compounds: Glycolic acid, Hyaluronic acid, Lactic acid and Salicylic acid. Concentrations where no or minimal inhibition was observed can be used in bacterial composition to enhance the features of cosmetic or pharmaceutical compositions.

FIG. 9 depicts results of a pilot clinical study recorded by a dermatologist. 10 subjects with acne vulgaris were visually evaluated by the dermatologist at week 0, week 1 (day 7) and week 3 (day 21) and lesion reduction was noted. In week 1, subjects were administered with Benzoyl Peroxide. In weeks 2 and 3, subjects were administered with bacterial compositions. Reduced lesions were recorded in 4 subjects at the end of the week 1 (after Benzyol Peroxide application) and in 5 subjects at the end of the week 3 (after bacterial composition application). Additionally, skin irritation was evaluated during the study.

FIG. 10 depicts the viability and cell lysis of Seb E6/E7 sebocytes that was measured after 5 days of exposure to different concentrations of linoleic acid and its conjugated isomer t10, c12 linoleic acid. Commercial kits were used according to manufacturer instructions XTT assay (Thermo Fisher, product number X-6493) and LDH assays (Pierce, product number 88954).

FIG. 11 shows the relative amount of neutral lipids stained with HCS LipidTOX reagent deep reed after a 72 h stimulation with varying concentrations of trans-10, cis 12 linoleic acid. An image at 5× magnification was taken from each well and then the relative fluorescence intensity quantified. Each condition was measured in triplicates. As a control, the cells were either unstimulated (blank) or stimulated with cis-9, cis-12 linoleic acid (not shown).

FIG. 12 shows the same experimental setup as in FIG. 11, except that for the evaluation, individual cells were randomly selected in the wells at a 20× magnification and then the relative fluorescence intensity was measured. As a negative control, a non-stimulated blank was used and as positive control, the cells were stimulated for lipogenesis with cis-9, cis-12 linoleic acid.

FIG. 13 shows the different conversion rates of cis-9, cis-12 linoleic acid towards trans-10, cis 12 linoleic acid for two P. acnes strains (C3, A 1). Both strains rapidly degrade the linoleic acid at the beginning; however, while strain A1 completely depletes the cis-9, cis-12 isomer from the media in 48 h, strain C1 slows down the degradation after an initial plunge. This indicates different steady state levels tolerated in vivo by both strains.

FIG. 14 depicts the degradation of cis-9, cis-12 linoleic acid by different P. acnes strains. For each strain, the remaining amount of cis-9, cis-12 linoleic acid after 15 h of shaking incubation is represented. All strains were normalized according to their OD before inoculation and the starting concentration of cis9, cis12 linoleic acid in the media was 500 ppm. The different strains show significant differences in their degradation rate, with A1 degrading linoleic acid the fastest.

FIG. 15 depicts treatment durability effects of bacterial compositions. The six different formulations were tested for durability. P. acnes population in areas treated with the formulations and with an empty solution were compared at several days during and after treatment (18 patients). Comparison is carried out by measuring spearman correlation between P. acnes population in the treated area, and the untreated area. Treatment effects take a few days to alter microbiome composition and last for 2-3 weeks.

DETAILED DESCRIPTION

Provided herein are compositions and methods for modulation of the skin microbiome. It is surprisingly demonstrated that the skin microbiome of a recipient can be modified to resemble the skin microbiome of a donor and that administration of compositions comprising live P. acnes bacterial strains can improve symptoms of acne. Compositions comprising one or more live bacterial strains are described herein for use in maintaining healthy skin, such as skin that is free of acne, or for treating or preventing acne. The live bacterial strains include one or more strains of P. acnes. As demonstrated herein, compositions comprising one or more live bacterial strains can help the human skin to revert microbiome disease states to healthy microbiome states.

Without wishing to be bound by any theory, it is proposed herein that P. acnes converts a signal precursor molecule (linoleic acid), which is naturally present in the sebum, to an active signaling molecule (trans-10, cis-12 linoleic acid), which stimulates in return sebum secretion, which is important for P. acnes colonization of the skin. Significantly, the production of this signaling molecule provides a connection between different aspects of the current understanding of the onset of acne.

This invention is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The invention is capable of other embodiments and of being practiced or of being carried out in various ways. Also, the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having.” “containing,” “involving,” and variations thereof herein, is meant to encompass the items listed thereafter and equivalents thereof as well as additional items.

Aspects of the invention relate to the microbiome. As used herein, “microbiome” refers to all of the microorganisms inhabiting the body. The human microbiome has a fundamental role in human health and disease (Consortium, 2012; NIH HMP Working Group et al., 2009). The development of Next Generation Sequencing (NGS) technologies has allowed the study of these microbial communities with an unprecedented depth and resolution (see Human Microbiota issue, Nature 2012). More than 10,000 different bacterial strains colonize the human body, and there are ten times more bacteria than human cells in an average human body. Recent research has indicated that the composition of bacterial communities in the body is tightly connected to the health of the human body (Belkaid and Segre, 2014: Consortium, 2012; Zhao, 2010). As a result, distortions of the microbiome are linked to a variety of diseases.

The gut microbiome, and methods for targeted manipulation of the gut microbiome, has been investigated in depth (Doré and Blottière, 2015). An example of such a therapy is the treatment of the antibiotic-resistant bacteria Clostridium difficile with the help of “fecal transplantation” (van Nood et al., 2013; Olle, 2013).

Following from research related to the gut microbiome, researchers recently began to investigate the skin microbiome (Belkaid and Segre, 2014; Oh et al., 2014). The skin is colonized by a large number of microorganisms, most of which are beneficial or harmless (Grice and Segre. 2011). However, diseases such as acne vulgaris are associated with strong alterations of the microbiome (Bek-Thomsen et al., 2008; Holmes, 2013; Kong et al., 2012). Acne, in particular, is considered to be linked to a distortion of the human skin microbiome (Fitz-Gibbon et al., 2013). This distortion is likely caused by a specific subset of the skin bacterium P. acnes (Lomholt and Kilian, 2010).

Herein, compositions and methods apply knowledge of the skin microbiome to develop treatments against skin disorders that originate or are influenced by distortions of the skin microbiome.

Acne

As used herein, “acne vulgaris” and “acne” are used interchangeably and refer to a skin condition that affects millions of people worldwide and is especially prevalent in teenagers. Acne is frequently associated with the formation of inflammatory and non-inflammatory lesions on the skin. Without wishing to be bound by any theory, acne may be associated, at least in part, with hair follicles that become clogged and/or inflamed. Acne is considered to be linked to the distortion of the human skin microbiome. This distortion may be caused by specific strains of the skin bacterium P. acnes (Fitz-Gibbon et al., 2013; Holmes. 2013; Lomholt and Kilian, 2010).

The development of acne is linked to the onset of sebum secretion from the sebaceous glands (Makrantonaki et al., 2011; Zouboulis, 2004). Also, the population density of P. acnes is directly linked to the amount of sebum produced (Kearney et al., 1984; King et al., 1982; Mourelatos et al., 2007). However, a clear molecular link between the presence of P. acnes and the disease acne, could until now, not be established. This is due, at least in part, to the fact that the skin of most adult humans is colonized by P. acnes, while symptoms of acne do not occur in many of those adults. In order for acne to occur, an inflammatory reaction must be triggered, which is accompanied by a change in the volume and composition of the sebum (Pappas et al., 2009).

Currently, standard treatment for acne is either long-term antibiotic treatment, such as treatment with Macrolide and/or Tetracycline antibiotics, or the systemic use of Isotretinoin (Berson et al., 2003). These treatments exhibit strong side effects and high relapse rates. For example, Isotretinoin causes skin irritation and also has teratogenic effects (causing birth defects) (McLane, 2001). In addition, the relapse rate with Isotretinoin is also unfavourable, at above 40% (Azoulay et al., 2007). Isotretinoin has been shown to reduce the volume of sebum production, thereby indirectly reducing the bacterial density on the skin (King et al., 1982). While antibiotics am a common treatment, in the last several decades, the number of bacterial strains that are resistant to one or more antibiotics has increased dramatically. (Leyden, 2001; Ross et al., 2001).

Another group of acne treatments include over-the-counter (OTC) products and cosmetics. Commonly used OTC products are broadband disinfection agents including benzoyl peroxide (e.g. Benzaknen, Galderma S. A., Lausanne, Switzerland and Aknefug, Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld. Germany) and salicylic acid. Additionally, there are a number of natural product lines which have limited or no proven efficacy.

Current therapies for skin disorders such as acne, that are linked to a distortion of the microbiome, are either ineffective or they are accompanied by severe side effects (McLane, 2001; Tripathi et al., 2013). Usually, the skin of a subject with acne improves during classical treatments, such as with antibiotics or hormones. However, the subject in most cases relapses after the end of the treatment. Isotretinoin has about a 41% relapse rate (Azoulay et al., 2007). Therefore, subjects are required to undergo long term treatments to keep the beneficial effects. This extreme relapse rate can be explained by the recolonization of the skin with the microbiome after stopping the therapy (FIG. 1).

Compositions and methods described herein address an unmet need for an effective treatment of acne without notable side effects, and with prevention of relapse. The novel approach described herein can involve transplantation of a healthy microbiome. Surprisingly, strains of P. acnes, the same bacterial species that is thought to be involved in causing acne, can be used to treat or prevent acne, or to maintain skin in a condition where it is free of acne. Described herein are compositions comprising one or more live bacterial strains that can provide an improved skin condition without causing notable side effects. The live bacterial strains within the compositions described herein are P. acnes bacterial strains.

In some embodiments, the composition is a cosmetic. As used herein, a “cosmetic” refers to a product that is intended to enhance appearance. Cosmetic composition comprising one or more live bacterial strains as described herein can also be referred to as a “cosmeceuticals” (Draelos, 2009).

Aspects of the invention relate to administering compositions comprising one or more live P. acnes bacterial strains to the skin of a subject either alone, in combination with other therapies, or following another therapy. In some aspects, a composition comprising one or more live P. acnes bacterial strains can help the skin revert from a microbiome disease state to a healthy microbiome state. In some embodiments, the skin of the subject has already been treated with a standard acne therapy, such as with antibiotics, disinfectants, or hormones. Compositions comprising one or more live P. acnes bacterial strains described herein can be used as complementary recovery methods to standard treatments for acne, whereby the composition comprising one or more live P. acnes bacterial strains can reduce the relapse rate of acne after antibiotic treatment. For example, a composition comprising one or more live P. acnes bacterial strains can be applied after an antibiotic or disinfectant treatment when the skin of a subject is cleared of the majority of its natural bacteria. The live bacteria in the composition can displace pathogenic bacterial strains and help to recover a diverse, healthy and balanced skin microbiome. Accordingly, in some embodiments, methods described herein involve eradicating pathogenic bacterial strains from the skin and then adding live P. acnes bacteria to the skin to create a healthy skin microbiome.

Compositions comprising one or more live P. acnes bacterial strains as described herein can be used to decrease or increase the volume of the sebum production of an individual. Compositions comprising one or more live P. acnes bacterial strains as described herein can also be used to produce trans-10, cis-12 linoleic acid in the follicles or sebaceous glands and thereby deliver this active compound to the environment of the sebaceous glands. These methods circumvent problems associated with the standard topical application of trans-10, cis-12 linoleic acid.

Compositions comprising one or more live P. acnes bacterial strains as described herein can also be used to increase or decrease the bacterial density on the skin by providing a bacterial strain to the skin which will increase or decrease the sebum production on the skin, thereby indirectly changing the bacterial density.

Compositions comprising one or more live P. acnes bacterial strains as described herein can also be used to modify the ratio of select bacterial species compared to other bacterial species or compared to other components of the microbiota such as fungi or mites by administering a live bacterial strain to the skin that alters the sebum production, thereby indirectly altering the bacterial density of P. acnes on the skin.

Compositions comprising one or more live P. acnes bacterial strains as described herein can be used to maintain healthy skin, such as skin that is free of acne. In some embodiments, administration of such compositions can assist in preventing formation of acne. In some embodiments, such compositions can be used to treat acne or can be used to prevent reoccurrence of acne in a subject who has received a standard acne treatment.

The compositions comprising one or more live P. acnes bacterial strains include one or more strains of live bacteria that naturally colonise the skin. In some embodiments, the one or more strains are naturally occurring. However, the composition comprising the one or more bacterial strains is not naturally occurring. The composition comprising the one or more bacterial strains has different properties than the individual strains in nature.

Propionibacterium acnes (P. acnes)

P. acnes is a species of anaerobic Gram-positive rod bacteria that is associated with acne as well as other conditions such as chronic blepharitis and endophthalmitis. P. acnes strains are present on the skin of most people. It has been reported that some strains of P. acnes are pathogenic, while other strains of P. acnes are not. (Fitz-Gibbon et al., 2013; Lomholt et al., 2010.) As used herein, “pathogenic” P. acnes strains refers to P. acnes strains that are associated with acne. Disclosed herein are assays by which pathogenic and non-pathogenic strains of P. acnes can be identified and selected.

Strains of P. acnes have been shown to differ significantly in their metabolism and phenotypic behavior (Lomholt and Kilian, 2010). These differences include but are not limited to expressing neuraminidase, α-glucosidase or hyaluronidase and the ability to perform hemolysis of horse blood, ribose fermentation, erythritol fermentation or sorbitol fermentation. Further it has been shown that P. acnes express an active linoleic acid isomerase, which specifically converts cis 9, c-12 linoleic acid into trans-10, cis-12 linoleic acid (Rosson et al., 2004). Linoleic acid is a key molecule in the regulation of sebum production and a reduction of linoleic acid has been linked in multiple studies to the onset of acne (Downing et al., 1986; Letawe et al., 1998).

Further it has been shown that P. acnes dead cells or supernatants are able to increase lipid production in hamster sebocytes (Iinuma et al., 2009a).

Species of P. acnes have been classified into types I-III, further including subtypes: IA and IB. (Lomholt et al.) IA has been further subdivide into IA₁ and IA₂(McDowell et al., 2012). Genetic analysis of P. acnes strains has been conducted to determine which strains may be pathogenic and associated with acne, and which strains may be non-pathogenic and not associated with acne. (Fitz-Gibbon et al., 2013. Lomholt et al., 2010, and Kasimatis et al., 2013). In some embodiments, a non-pathogenic P. acnes strain is a strain from one of the following classes of P. acnes: I-2. II and IB. In some non-limiting embodiments, a non-pathogenic strain of P. acnes is selected from the group of non-pathogenic strains consisting of: D1. A5, C3. H1. H2. H3, K1, K2, K4, K6, K8. K9. L, and F4, as described in Scholz et al. (2014) PLOS ONE 9(8) e104199.

As described in Scholtz et al., and as would be understood by one ordinary skill in the art, strains of P. acnes can be identified using single-locus sequence typing (SLST), involving PCR amplification and DNA sequencing of a target locus. An SLST scheme for P. acnes was developed and described in Scholz et al. using the target locus PPA2385 A P. acnes database associated with the SLST scheme described in Scholtz et al. is available online at http://medbac.dk/slst/pacnes. Users can enter a P. acnes sequence into the online database to identify SLST fragments.

As used herein, “typing” a bacterial strain refers to identifying the bacterial strain, such as by using SLST. Table 1 in the Examples section lists allelic sequences used in SLST to identify strains described herein, such as P. acnes strains D1, A5, C3, H1, H2. H3. K1, K2, K4, K6, K8, K9, L1, and F4. One of ordinary skill in the art would understand the strain designations used herein, corresponding to those disclosed in Scholtz et al., and would understand how to identify whether a P. acnes strain corresponds to any of these specific strains by using, e.g., SLST.

Strains of P. acnes included in bacterial compositions described herein can be naturally occurring or can be genetically modified. Strains that are genetically modified can be modified by natural mutagenesis and/or by genetic engineering. In some embodiments, the genetic modification of the P. acnes strain increases or decreases its linoleic acid isomerase activity.

In some aspects, compositions comprising one or more live P. acnes bacterial strains described herein include the P. acnes strain H1 (6609). (Hunyadkürti et al.) The genome of this P. acnes strain has been sequenced and is available at GenBank accession number CP002815. (Hunyadkürti et al.) In some embodiments, compositions comprising one or more live P. acnes bacterial strains described herein include strains of P. acnes that have certain CRISPR/CAS9 sequences. (Brüggemann, 2012, Fitz-Gibbon 2013). In some embodiments, compositions comprising one or more live P. acnes bacterial strains described herein include comprise one or more of P. acnes strains K1. K4 and H1 (6609). In some embodiments, compositions comprising one or more live P. acnes bacterial strains described herein comprise each of P. acnes strains K1, K4, D1, A5, C3 and H1 (6609).

Bacterial compositions described herein comprise one or more strains of P. acnes. For example, a bacterial composition can comprise 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 or more than 20 strains of P. acnes. One or more of the strains of P. acnes can be non-pathogenic strains. In some embodiments, all of the strains of P. acnes in a bacterial composition are non-pathogenic strains. In some embodiments strains of P. acnes are genotyped in order to identify the strain and to make a selection as to whether to include the strain in a composition. Strains of P. acnes included in bacterial compositions described herein can be selected to increase or decrease lipid production.

Aspects of the invention relate to mixtures of P. acnes strains. Selection of P. acnes strains can involve, at least in part, a determination of whether the strain is pathogenic. This determination can be based on public information, prior reports, and/or routine experimental testing to determine whether a P. acnes strain is pathogenic or not. In some embodiments, only non-pathogenic P. acnes strains are selected.

Selection of P. acnes strains can also involve, at least in part, a determination of which strains, or combinations of strains, are stable in conditions that would be appropriate for use in a cosmetic or pharmaceutical composition. In some embodiments, P. acnes strains that exhibit increased stability are selected. Stability can be assessed using methods known in the art, such as by measuring a change in colony-forming units (CFU). Strains of P. acnes included in bacterial compositions described herein can be naturally occurring or can be genetically modified. Strains that are genetically modified can be modified by natural mutagenesis and/or by genetic engineering. In some embodiments, the genetic modification of the P. acnes strain is made to influence the production of trans-10, cis-12 linoleic acid. In some embodiments, P. acnes strains show different level of linoleic acid isomerase, which can be used to classify bacterial strains and/or to select specific bacterial strains.

In some embodiments, one or more of the P. acnes bacterial strains is selected based on its ability to produce trans-10, cis-12 linoleic acid. In some embodiments, one or more of the P. acnes bacterial strains is selected based on the amount of trans-10, cis-12 linoleic acid it produces in its natural environment. In some embodiments, one or more of the P. acnes bacterial strains is selected based on the maximum concentration of trans-10, cis-12 linoleic acid it produces. In some embodiments, one or more of the P. acnes bacterial strains is selected based on the activity of the enzyme linoleic acid isomerase it produces. In some embodiments, a P. acnes strain with no linoleic acid activity is selected. In other embodiments, a P. acnes strain with low levels of linoleic acid activity is selected. In other embodiments, a P. acnes strain with high levels of linoleic acid activity is selected.

In some embodiments, production of trans-10, cis-12 linoleic acid by P. acnes strains is detected using methods described in and incorporated by reference from U.S. Pat. No. 6,743,609, entitled “Linoleate isomerase.” which granted on Jun. 1, 2004. In some embodiments, the amount of trans-10, cis-12 linoleic acid produced is detected using FAME (Fatty acid methyl esters) and/or GC (Gas Chromatography).

In some embodiments, a P. acnes strain can convert from 500 pm linoleic acid up to 250 ppm trans-10, cis-12 linoleic acid and then can keep this concentration constant. In some embodiments, a P. acnes strain is selected that has higher capacity for conversion of linoleic acid to trans-10, cis-12 linoleic acid. In other embodiments, a P. acnes strain is selected that has lower capacity for conversion of linoleic acid to trans-10, cis-12 linoleic acid.

Without wishing to be bound by any theory, in some embodiments, a bacterial composition in which the P. acnes strains have zero to low levels of linoleic acid isomerase may be beneficial for preventing or treating acne because such compositions may reduce sebum secretion. In some embodiments, such a composition may be helpful in avoiding relapse of acne after finishing standard acne treatment (such as disinfection or antibiotics).

In some embodiments, bacterial compositions can be used to increase levels of trans-10, cis-12 linoleic acid in the skin follicles. In other embodiments, bacterial compositions can be used to decrease levels of trans-10, cis-12 linoleic acid in the skin follicles. In some embodiments, a combination of P. acnes strains is used to deliver trans-10, cis-12 linoleic acid directly to the sebaceous glands either for cosmetic or medical purposes.

In some embodiments, a bacterial composition described herein is used to reduce sebum production on skin that has high levels of sebum production, such as oily skin. In other embodiments, a bacterial composition described herein is used to increase sebum production on skin that has low levels of sebum production, such as dry skin. In some embodiments, a combination of strains with high linoleic acid isomerase activity is applied to the skin of individuals who lack sufficient sebum production. In some embodiments, such individuals are elderly people who may experience a decrease in sebum production.

In some embodiments, the amount of trans-10, cis-12 linoleic acid produced by a P. acnes strain is evaluated by comparing production of trans-10, cis-12 linoleic acid in the strain being tested to a P. acnes strain that is known not to produce trans-10, cis-12 linoleic acid or that produces negligible or lower than average amounts of trans-10, cis-12 linoleic acid. In other embodiments, the amount of trans-10, cis-12 linoleic acid produced by a P. acnes strain is evaluated by comparing production of trans-10, cis-12 linoleic acid in the strain being tested to a P. acnes strain that is known to produce average or higher than average amounts of trans-10, cis-12 linoleic acid. In some embodiments, the relative amount of trans-10, cis-12 linoleic acid produced is measured or evaluated. In other embodiments, the absolute amount of trans-10, cis-12 linoleic acid produced is measured or evaluated.

In some embodiments, the amount of cis-9, cis-12 linoleic acid degraded by a P. acnes strain is evaluated by comparing the degradation rate of cis-9, cis-12 linoleic acid in the strain being tested to a P. acnes strain that is known not to degrade cis-9, cis-12 linoleic acid or that degrades negligible or lower than average amounts of cis-9, cis-12 linoleic acid. In other embodiments, the amount of cis-9, cis-12 linoleic acid degraded by a P. acnes strain is evaluated by comparing degradation rate of cis-9, cis-12 linoleic acid in the strain being tested to a P. acnes strain that is known to have an average or higher degradation rate than average of cis-9, cis-12 linoleic acid. In some embodiments, the relative amount of cis-9, cis-12 linoleic acid degraded is measured or evaluated. In other embodiments, the absolute amount of cis-9, cis-12 linoleic acid degraded is measured or evaluated.

In some embodiments, one or more of the P. acnes bacterial strains within the composition exhibits slow or negligible degradation or conversion of cis-9, cis-12 linoleic acid. In some embodiments, all of the P. acnes bacterial strains within the composition exhibit slow or negligible degradation or conversion of cis-9, cis-12 linoleic acid.

In some embodiments, one or more of the P. acnes bacterial strains within the composition is selected based on its slow or negligible degradation or conversion of cis-9, cis-12 linoleic acid. In some embodiments, one or more of the P. acnes bacterial strains within the composition is selected based on the amount of cis-9, cis-12 linoleic acid it degrades in its natural environment. In some embodiments, one or more of the P. acnes bacterial strains within the composition is selected based on the maximum concentration of cis-9, cis-12 linoleic acid it degrades.

In some embodiments, one or more of the P. acnes bacterial strains within the composition is genetically modified to degrade less cis-9, cis-12 linoleic acid or to degrade cis-9, cis-12 linoleic acid more slowly.

Individual and combinations of strains can be tested using routine methods to determine which combinations lead to stable compositions. In some embodiments, such compositions are stable at room temperature for at least 1 week, 2, weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks, 14 weeks, 15 weeks, 16 weeks, 17 weeks, 18 weeks, 19 weeks, 20 weeks, 21 weeks, 22 weeks, 23 weeks, 24 weeks, 25 weeks, 26 weeks, 27 weeks, 28 weeks, 29 weeks, 30 weeks or more than 30 weeks. In some embodiments, such compositions are stable at room temperature for at least 1 month. 2 months, 3 months, 4 months, 5 months, 6 months or more than 6 months.

In some embodiments, compositions are stable when refrigerated, at approximately 4° C. for at least 1 week. 2, weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks. 8 weeks. 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks, 14 weeks, 15 weeks, 16 weeks, 17 weeks, 18 weeks, 19 weeks, 20 weeks, 21 weeks, 22 weeks, 23 weeks, 24 weeks, 25 weeks, 26 weeks. 27 weeks. 28 weeks. 29 weeks. 30 weeks or more than 30 weeks. In some embodiments, compositions are stable when refrigerated, at approximately 4° C. for at least 1 month, 2 months, 3 months, 4 months, 5 months, 6 months or more than 6 months.

As discussed in Example 5, in some embodiments, a bacterial composition is formulated by taking a sample from the skin microbiome of a donor subject. For example, the sample can be taken from a subject who does not have acne. In other embodiments, a sample is taken from a subject who has mild, moderate or severe acne. In some embodiments, the sample is taken from a subject who has acne or is susceptible to acne, but bacterial strains associated with causing acne are removed from the sample. A sample can be cultured and can optionally be combined with other components to form a bacterial composition. In other embodiments, a bacterial composition can be formed from one or more isolated bacterial strains.

A sample taken from a donor subject can be tested to see if it contains non-pathogenic P. acnes strains. In some embodiments, one or more non-pathogenic P. acnes strains from the skin of a donor subject are selected and are administered to a recipient subject. The recipient subject can be the same subject as the donor subject or can be a different subject from the donor subject.

In some embodiments, a bacterial composition can include one or more strains of other bacteria, such as other non-pathogenic bacteria, in addition to one or more strains of P. acnes. In some embodiments, the one or more strains of other non-pathogenic bacteria have antibiotic properties. In some embodiments, a bacterial composition can include one or more S. epidermidis strains.

Linoleic Acid and its Isomer Trans 10, Cis 12 Linoleic Acid

Linoleic acid is a C18 fatty acid with two unsaturated double bonds. Usually, the main isomer is cis-9, cis-12. This isomer is also secreted as free fatty acid in the sebum. In vitro, linoleic acid stimulates the lipid production in sebocytes and may be involved in a feedback loop regulating sebum production. It also has antibacterial properties, with different P. acnes strains exhibiting different susceptibility to linoleic acid (Hong Lioe Ko et al., 1978; Madli Puhvel and Reisner, 1970). However linoleic acid also serves as a stimulant for sebum production, which represents the food source of P. acnes. Without wishing to be bound by any theory, an equilibrium may exist, represented by the linoleic acid concentration in the sebum determined by the bacterial population and the host's sebum production. This equilibrium depends on the degradation/conversion rate of cis, cis-12 linoleic acid by the P. acnes population colonizing the follicle.

Conjugated isomers of linoleic acid, namely cis-9, cis-11 linoleic acid and trans-10, cis-12 linoleic acid, have attracted attention as food supplements (Churruca et al., 2009). Linoleic acid trans-10, cis 12 acts on the PPAR receptor family (peroxisome proliferator-activated receptor) (Moya-Camarena et al., 1999). Activation of PPAR-α activates lipid synthesis in epidermal skin models, including cholesterol (Rivier et al., 2000). It has also been reported that trans-10, cis-12 linoleic acid increases ROS (reactive oxygen species) and has anticancer activity (Pierre et al., 2013).

Staphylococcus epidermidis (S. epidermidis)

S. epidermidis is a Gram-positive bacteria that is a normal component of human skin. S. epidermidis can produce 5 lantibiotics, including: epidermin, Pep5, epicidin 280, epilancin K7, and epidermicin NI01. A lantibiotic refers to an antibiotic-like peptide that contains the non-protein amino acids lanthionin and 3-methyllanthionine (Schnell et al., 1988). Epidermin is highly active against P. acnes (Allgaier et al., 1985). Gotz et al. describe epidermin in further detail. Wang et al. report that S. epidermidis can mediate fermentation of glycerol to inhibit the growth of P. acnes.

Strains of S. epidermidis included in bacterial compositions described herein can be naturally occurring or can be genetically modified. Strains that are genetically modified can be modified by natural mutagenesis and/or by genetic engineering. In some embodiments, the genetic modification of the S. epidermidis strain increases its antibiotic properties. In some aspects a bacterial composition can contain one or more strains of P. acnes and one or more strains of S. epidermidis. The one of more strains of P. acnes can be resistant to the antibiotic properties of the one or more strains of S. epidermidis. In some embodiments, the one or more strains of P. acnes are genetically modified to increase their resistance to antibiotic properties of one or more other bacterial strains, such as one or more strains of S. epidermidis. In some embodiments, the one or more P. acnes strains are modified by natural mutagenesis and/or by genetic engineering to increase their resistance to the antibiotic properties of one or more other bacterial strains.

In some embodiments, compositions comprising one or more live P. acnes bacterial strains described herein can contain one or more of an antibiotic, a disinfectant, or salicylic acid. One of ordinary skill in the art would appreciate that any antibiotic or disinfectant may be compatible with certain embodiments of the invention.

Skin Microbiome Transplantation

Aspects of the invention relate to modulation of a skin microbiome, such as by transplantation. Transplantation can occur between one or more subjects. In some embodiments, transplantation occurs in one subject and the same subject is the donor and the recipient. In other embodiments, transplantation occurs between two or more subjects. In some embodiment, there is one donor subject and one recipient subject. In other embodiments, there are multiple donor subjects and/or multiple recipient subjects. Multiple methods of transplantation can be used, resulting in different formulations of a bacterial composition. In some embodiments, a non-modified microbiome is transplanted, meaning that a donor microbiome is isolated, and prepared for delivery to a recipient. In other embodiments, a formulated microbiome is transplanted, meaning that a donor microbiome is isolated, optionally genotyped, and specific strains are selected for a formulation (e.g., strains with specific genotypes). In some embodiments a formulated and gene edited microbiome is transplanted, meaning that a donor microbiome is isolated, genotyped, specific strains are selected, genetic mutants are isolated from the strains, and a formulation is generated.

In some embodiments, methods comprise: obtaining one or more live bacterial strains from the skin of a donor subject, wherein the live bacterial strains are P. acnes strains; determining whether the one or more live bacterial strains are pathogenic; and administering the one or more live bacterial strains to the skin of a recipient subject in need thereof following administration of a disinfectant or antibiotic to the skin of the subject if the one or more live bacterial strains are not pathogenic. In some embodiments, an assay is conducted to determine whether the one or more live P. acnes strains are pathogenic. For example, an assay can be conducted to assess how the live bacterial strains convert or degrade cis-9, cis-12 linoleic acid. In some embodiments, one or more of the P. acnes bacterial strains within the composition is selected based on its slow or negligible degradation or conversion of cis-9, cis-12 linoleic acid.

Treatment

As used herein, the term treat, treated, or treating when used with respect to a disorder such as acne refers to improving at least one symptom of acne, such as a reduction or improvement of lesions associated with acne. As used herein, preventing acne refers to preventing formation of symptoms of acne such as lesions, and/or preventing at least one symptom of acne from getting worse, such as preventing further lesions or preventing existing lesions from becoming worse.

Subjects

Compositions described herein can be administered to human or non-human subjects. In some embodiments, a subject is a human or non-human who has acne or is at risk of developing acne. In some embodiments, the subject is a human. In some embodiments, the subject is a domestic animal such as a house pet, such as a cat or a dog. In some embodiments, the subject is a farm animal such as a cow, goat, horse, pig or sheep. It should be appreciated that any animal that has skin could be compatible with aspects of the invention.

Effective Amounts

Compositions described herein can be administered in effective amounts. The term “effective amount” of a composition of the invention refers to the amount necessary or sufficient to realize a desired biologic effect. For example, an effective amount of a composition for treating acne is that amount sufficient to improve at least one symptom of acne, such as a reduction or improvement in lesions. The effective amount for any particular application can vary depending on such factors as the condition being treated, the particular composition being administered, the size of the subject, or the severity of the condition. One of ordinary skill in the art can empirically determine the effective amount of a particular composition of the invention without necessitating undue experimentation.

Compositions

Compositions, including cosmetic or pharmaceutical compositions, for topical administration, include transdermal patches, ointments, lotions, creams, gels, drops, sprays, including aerosol sprays, suppositories, liquids, serums or powders. In some embodiments, the preparation is a two-component dispensing system. In addition, conventional pharmaceutical carriers, aqueous, powder or oily bases, or thickeners may be used in pharmaceutical preparations for topical administration. Examples of such ingredients include various hydroxylated compounds, such as monomeric glycols, e.g., propylene glycol, ethyl alcohol, glycerin and butylene glycol, polymeric moisturizers such as polyglycerylmethacrylate, derivatives of palmitates and stearates, triglycerides of fatty acids, lanolin, vegetable or mineral oils, and waxes.

In some embodiments, compositions include media for stabilizing bacterial count. Media can include pure water, PBS, peptone, and/or a diluted or undiluted version of a suitable growth medium or any combination thereof. In some embodiments, the bacterial composition is a gel containing a low percentage of peptone which assists in stabilizing the bacteria. In some embodiments, the percentage of peptone in the bacterial composition is about 0.05% or about 0.1%. The percentage of peptone can range in some embodiments from 0.005%-1%. For example, the percentage of peptone can be about 0.005, 0.006, 0.007, 0.008, 0.009, 0.01, 0.02, 0.03, 0.04, 0.05, 0.06, 0.07, 0.08, 0.09, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9 or 1.0%. In some embodiments, the percentage of peptone is less than 0.005%. In some embodiments, the percentage of peptone is greater than 1%. In other embodiments, a suitable growth medium us used in place of peptone.

In some embodiments, the composition contains a buffer component to help stabilize the pH. In some embodiments, the pH is between 4.5-8. For example, the pH can be approximately 4.5, 4.6, 4.7, 4.8, 4.9, 5.0, 5.1, 5.2, 5.3, 5.4, 5.5, 5.6, 5.7, 5.8, 5.9, 6.0, 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.7, 6.8, 6.9, 7.0, 7.1, 7.2, 7.3, 7.4, 7.5, 7.6, 7.7, 7.8, 7.9 or 8.0, including any value in between. In some embodiments, the pH is approximately 7.0.

Non-limiting examples of buffers can include ACES, acetate. ADA, ammonium hydroxide, AMP (2-amino-2-methyl-1-propanol), AMPD (2-amino-2-methyl-1,3-propanediol), AMPSO, BES, BICINE, bis-tris, BIS-TRIS propane, borate, CABS, cacodylate, CAPS, CAPSO, carbonate (pK1), carbonate (pK2). CHES, citrate (pK1), citrate (pK2), citrate (pK3), DIPSO. EPPS, HEPPS, ethanolamine, formate, glycine (pK1), glycine (pK2), glycylglycine (pK1), glycylglycine (pK2), HEPBS, HEPES, HEPPSO, histidine, hydrazine, imidazole, malate (pK1), malate (pK2), maleate (pK1), maleate (pK2), MES, methylamine. MOBS, MOPS, MOPSO, phosphate (pK1), phosphate (pK2), phosphate (pK3), piperazine (pK1), piperazine (pK2), piperidine. PIPES, POPSO, propionate, pyridine, pyrophosphate, succinate (pK1), succinate (pK2), TABS, TAPS, TAPSO, taurine (AES), TES, tricine, triethanolamine (TEA), and Trizma (tris).

In some embodiments the formulation includes a thickener. Non-limiting examples of thickeners can include hydroxyethylcelluloses (e.g. Natrosol), starch, gums such as gum arabic, kaolin or other clays, hydrated aluminum silicate, fumed silica, carboxyvinyl polymer, sodium carboxymethyl cellulose or other cellulose derivatives, ethylene glycol monostearate and sodium alginates.

In some embodiments, the bacterial composition exhibits a stable CFU over at least three months at mom temperature. In some embodiments, the CFU count shortly fluctuates in the initial storage phase (e.g., 2 weeks) and then stabilizes.

In some embodiments, compositions comprise emollients such as those disclosed in an incorporated by reference from U.S. Pat. No. 5,525,336. Non-limiting examples of emollients include stearyl alcohol, glyceryl monoricinoleate, glyceryl monostearate, propane-1,2-diol, butane-1,3-diol, mink oil, cetyl alcohol, isopropyl isostearate, stearic acid, isobutyl palmitate, isocetyl stearate, oleyl alcohol, isopropyl laurate, hexyl laurate, decyl oleate, octadecan-2-ol, isocetyl alcohol, cetyl palmitate, dimethylpolysiloxane, di-n-butyl sebacate, isopropyl myristate, isopropyl palmitate, isopropyl stearate, butyl stearate, polthylene glycol, triethylene glycol, lanolin, sesame oil, coconut oil, arrachis oil, castor oil, acetylated lanolin alcohols, petroleum, mineral oil, butyl myristate, isostearic acid, palmitic acid, isopropyl linoleate, lauryl lactate, myristyl lactate, decyl oleate, myristyl myristate.

In some embodiments, a protein stabilizing agent such as those disclosed in an incorporated by reference from U.S. Pat. No. 5,525,336 is included in the composition. Non-limiting examples include glycerol, ethylenediaminetetraacetic acid, cysteine, and proteinase inhibitors such as leupeptin, pepstatin, antipain, and cystatin.

In some embodiments, a humectant such as those disclosed in an incorporated by reference from U.S. Pat. No. 5,525,336 is included in the composition. Non-limiting examples of humectants include glycerin, sorbitol, sodium 2-pyrrolidone-5-carboxylate, soluble collagen, dibutylphthalate, gelatin.

In some embodiments, an astringent agent such as those disclosed in an incorporated by reference from U.S. Pat. No. 5,525,336 is included in the composition. Non-limiting examples of astringent agents include arnica flowers or extracts thereof, lower alkyl alcohols, witch hazel, boric acid, lactic acid, methol, camphor, zinc phenol sulphonate, aluminum acetate, aluminum sulfate, and zinc chloride or sulfate.

In some embodiments, a pigment such as those disclosed in an incorporated by reference from U.S. Pat. No. 5,525,336 is included in the composition. Non-limiting examples of pigments include titanium dioxide, micas, iron oxides, barium lake, calcium lake, aluminum lake, bismuth oxychloride, zirconium lake and calcium oxides.

In some embodiments, a coloring agent such as those disclosed in an incorporated by reference from U.S. Pat. No. 5,525,336 is included in the composition. Non-limiting examples of coloring agent include shikonin, β-carotene, paprika, monascus, safflower red, safflower yellow, red cabbage color, purple sweet potato color, lycopene, cacao color, grape color, cochineal, lac color, beet red, hematein, Red. No. 215, Red. No. 218, Red. No. 223. Red. No. 225, Orange No. 201, Orange No. 206, Yellow No. 201, Green No. 202, and Purple No. 201, Red. No. 2, Red. No. 3, Red. No. 102, Red. No. 104 (1), Red. No. 105 (1), Red. No. 106, Yellow No. 4, Yellow No. 5, Green No. 3, Blue No. 1, Blue No. 2, Red. No. 201, Red. No. 213, Red. No. 214, Red. No. 227, Red. No. 230 (1), Red. No. 230 (2), Red. No. 231, Red. No. 232, Orange No. 205, Orange No. 207, Yellow No. 202 (1), Yellow No. 202 (2), Yellow No. 203, Green No. 201, Green No. 204, Green No. 205, Blue No. 202, Blue No. 203, Blue No. 205, and Brown No. 201.

In some embodiments, UV-A and UV-B radiation filters, sunscreens, free-radical blockers, vitamin extracts, or antioxidants such as those disclosed in an incorporated by reference from U.S. Pat. No. 5,525,336 are included in compositions.

In some embodiments, a surfactant or a solvent such as those disclosed in an incorporated by reference from U.S. Pat. No. 5,525,336 is included in the composition. Non-limiting examples of solvents include water, ethyl alcohol, toluene, methylene chloride, isopropanol, n-butyl alcohol, castor oil, ethylene glycol monoethyl ether, diethylene glycol monobutyl ether, diethylene glycol monoethyl ether, dimethyl sulphoxide, dimethyl formamide and tetrahydrofuran, i) Anionic surfactants, such as metallic or alkanolamine salts of fatty acids for example sodium laurate and triethanolamine oleate; alkyl benzene sulphones, for example triethanolamine dodecyl benzene sulphonate; alkyl sulphates, for example sodium lauryl sulphate; alkyl ether sulphates, for example sodiumlauryl ether sulphate (2 to 8 EO); sulphosuccinates, for example sodium dioctyl sulphonsuccinate; monoglyceride sulphates, for example sodium glyceryl monostearate monosulphate; isothionates, for example sodium isothionate; methyl taurides, for example Igepon T; acylsarcosinates, for example sodium myristyl sarcosinate; acyl peptides, for example Maypons and lamepons; acyl lactylates, polyalkoxylated ether glycollates, for example trideceth-7 carboxylic acid; phosphates, for example sodium dilauryl phosphate; Cationic surfactants, such as amine salts, for example sapamin hydrochloride; quartenary ammonium salts, for example Quaternium 5, Quatemium 31 and Quaternium 18; Amphoteric surfactants, such as imidazol compounds, for example Miranol; N-alkyl amino acids, such as sodium cocaminopropionate and asparagine derivatives; betaines, for example cocamidopropylebetaine; Nonionic surfactants, such as fatty acid alkanolamides, for example oleic ethanolamide; esters or polyalcohols, for example Span; polyglycerol esters, for example that esterified with fatty acids and one or several OH groups; Polyalkoxylated derivatives, for example polyoxy:polyoxyethylene stearate; ethers, for example polyoxyethe lauryl ether, ester ethers, for example Tween; amine oxides, for example coconut and dodecyl dimethyl amine oxides. In some embodiments, more than one surfactant or solvent is included.

In some embodiments, preservatives, antiseptics, pigments or colorants, fragrances, masking agents, and carriers, such as water and lower alkyl, alcohols, such as those disclosed in an incorporated by reference from U.S. Pat. No. 5,525,336 are included in compositions.

In some embodiments wherein a composition is in a powder, the powders may include chalk, talc, fullers earth, colloidal silicon dioxide, sodium polyacrylate, tetra alkyl and/or trialkyl aryl ammonium smectites and chemically modified magnesium aluminum silicate as disclosed in an incorporated by reference from U.S. Pat. No. 5,525,336. In some embodiments, a composition can include a perfume.

When administered, the compositions of the invention are applied in a therapeutically effective, pharmaceutically acceptable amount as a pharmaceutically acceptable formulation. Any of the compositions of the present invention may be administered to the subject in a therapeutically effective dose. When administered to a subject, effective amounts will depend on the particular condition being treated and the desired outcome. A therapeutically effective dose may be determined by those of ordinary skill in the art, for instance, employing factors such as those described herein and using no more than routine experimentation.

In some embodiments, one or more of the following agents is included in compositions described herein: topical antibiotics (e.g., clindamycin, erythromycin, tetracycline, metronidazole), oral antibiotics (e.g., tetracycline, erythromycin, minocycline, doxycycline, clindamycin), topical retinoids (e.g., adapalene, tazarotene, tretinoin), oral retinoids (e.g., isotretinoin), benzoyl peroxide, salicylic acid, sulfur, azelaic acid, and antimicrobial peptides and derivatives thereof (e.g., lipohexapeptide HB1345, oligopeptide-10, magainins (e.g., pexiganan), protegrins (e.g., iseganan), indolicidins (e.g., omiganan. MBI 594AN), histatins (e.g., P113 P113D), human bactericidal/permeability-increasing proteins (e.g., XMP.629, neuprex), cathelicidins (e.g., cathelicidin-BF).

In some embodiments, compositions are administered in a topical form, such as in a cream or ointment. In some embodiments, administration of compositions described herein comprises part of a combination treatment or follows from an earlier treatment of the skin of a subject.

The appropriate amount of a composition to be applied can depend on many different factors and can be determined by one of ordinary skill in the art through routine experimentation. Several non-limiting factors that might be considered include biological activity and bioavailability of the agent, nature of the agent, mode of administration, half-life, and characteristics of the subject to be treated.

In some embodiments, the bacterial composition is not applied to subjects with sensitive skin. In some embodiments, when using a bacterial composition for the treatment or prevention of acne, the subject being treated avoids unnecessary sun exposure and uses a sunscreen. In some embodiments, if the treated skin is irritated, characterized by redness, swelling, burning, itching, or peeling, the product is used less frequently or in a lower concentration.

In some embodiments, a composition described herein is administered to the skin of a subject to maintain healthy skin. A composition can be administered once or multiple times. In some embodiments, a composition is administered at regular intervals while in other embodiments it is administered in irregular intervals. For example, a composition can be administered about every 15 minutes, 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 5 hours, 6 hours, 7 hours, 8 hours, 9 hours, 10 hours. 11 hours, 12 hours, 24 hours, 48 hours, 3 days, 4 days, 5 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks or more or less frequently including all values in between.

In some embodiments, a composition is administered to a subject who also receives or has previously received a standard acne treatment, such as a disinfectant or an antibiotic, as would be recognized by one of ordinary skill in the art. In some embodiments, the composition is administered in parallel with the standard acne treatment. In other embodiments, the composition is administered after the standard acne treatment. The composition can be administered either immediately after the previous treatment or there can be a delay between the previous treatment and administration of the composition. The composition can be administered once or multiple times after the previous treatment. In some embodiments, a composition is administered at regular intervals after the previous treatment while in other embodiments it is administered in irregular intervals after the previous treatment. For example, a composition can be administered about every 15 minutes, 30 minutes, 1 hour. 2 hours, 3 hours, 4 hours. 5 hours, 6 hours. 7 hours, 8 hours. 9 hours, 10 hours. 11 hours, 12 hours, 24 hours. 48 hours, 3 days, 4 days, 5 days. 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks or more or less frequently including all values in between after a previous treatment.

Aspects of the invention encompass mutating bacterial strains, such as in S. epidermis strains. Mutations can be made in some embodiments by selecting an amino acid substitution, or by random mutagenesis of a selected site in a nucleic acid or polypeptide. Variant polypeptides can be expressed and tested for one or more activities to determine whether a mutation provides a variant polypeptide with desired properties. Further mutations can be made to variants (or to non-variant polypeptides) which are silent as to the amino acid sequence of the polypeptide, but which provide preferred codons for translation in a particular host. The preferred codons for translation of a nucleic acid in, e.g., E. coli, are well known to those of ordinary skill in the art. Still other mutations can be made to the noncoding sequences of a gene or cDNA clone to enhance expression of the polypeptide. The activity of variant polypeptides can be tested by cloning the gene encoding the variant polypeptide into a bacterial or eukaryotic expression vector, introducing the vector into an appropriate host cell, expressing the variant polypeptide, and testing for a functional capability of the polypeptides as disclosed herein.

Bacterial cells according to the invention can be cultured in a variety of media, including rich or minimal media. As would be understood by one of ordinary skill in the art, routine optimization would allow for use of a variety of types of media. Media can be supplemented with various additional components, including sugar sources. Some non-limiting examples of supplemental components include glucose, amino acids, antibiotics and ATCC Trace Mineral Supplement. Similarly, other aspects of the medium, and growth conditions of the cells of the invention can be optimized through routine experimentation. For example, pH, temperature, and concentration of components within the compositions are non-limiting examples of factors which can be optimized.

Liquid and/or solid cultures used to grow cells associated with the invention can be housed in any of the culture vessels known and used in the art.

Kits

The present invention also provides any of the above-mentioned compositions in kits.

In some embodiments, a kit comprises a container housing live bacteria or a container housing freeze-dried live bacteria. Kits can include a second container including media such as peptone. Kits can also include instructions for administering the composition. In certain embodiments, instructions are provided for mixing the bacterial strains with other components of the composition. In some embodiments, a kit further includes an applicator to apply the bacterial composition to a subject.

The present invention is further illustrated by the following Examples, which in no way should be construed as further limiting. The entire contents of all of the references (including literature references, issued patents, published patent applications, and co pending patent applications) cited throughout this application are hereby expressly incorporated by reference.

EXAMPLES Example 1: Compositions Comprising Live Bacteria for Topical Administration to the Skin

A mixture of biologically active live bacteria for topical administration was prepared as follows. A sample of skin microbiome was taken from a donor. The sample was then cultured in the laboratory, and a formulation was prepared.

Methods for analysing the microbiome included DNA isolation, 16S amplification and large-scale amplicon sequencing, as well as bioinformatics for the taxonomic assignment and quantification of diversity in microbial communities. Steps included:

-   -   1. Isolation of bacterial strains from a donor. Bacteria were         collected using swabs.     -   2. Growth in the laboratory. Bacteria were grown in reinforced         clostridium agar in anaerobic conditions at 37° C.     -   3. Isolation and manipulation of the bacterial strains. The         sample was enriched for Propionibacterium strains and analyzed         for positive genotypes with SLST primers.     -   4. Formulation of a composition comprising one or more live         bacterial strains. Bacteria were collected from an agar plate         using a saline solution.     -   5. Application of the composition comprising one or more live         bacterial strains to the recipient. The donor microbiome was         applied using swabs.     -   6. Genotyping of the modified recipient microbiome, using an         NGS-based genotyping approach discussed below.         An NGS-based genotyping approach was used for identifying         different strains as follows:     -   1. The microbiome was collected using swabs     -   2. The sample was incubated at high temperature to isolate the         DNA. The QuickExtract™ kit from Epicentre. Chicago, Ill, was         used with some modifications. 80 microliters of 0.05M NaOH was         added to the suspension solution. The incubation was conducted         for 45 minutes at 60° C. followed by a 5 minute incubation at         95° C. After incubation, 9.2 microliters of 1 M Tris-HCl, pH 7.0         was added. 0.5 microliters of this mixture was used for PCR.     -   3. PCR was conducted on the sample using 16S primers, and SLST         allele to characterize the population. DNA preparation was         diluted 100× for PCR analysis. Samples were amplified using KAPA         polymerase (5 min 95° C.; 35 cycles of (98° C. 20 s, 62° C. 25         s, 72° C. 30 s); 1 min 72° C.     -   4. Library preparation. The library was constructed using two         rounds of PCR. The first round used 16S primers and SLST primers         which included sequences compatible with Ilumina sequencing. The         second round was used to barcode the different samples for         sequencing in a single Illumina flowcell.     -   5. Ilumina MiSeq sequencing was conducted.     -   6. Samples were analyzed using an internally developed         computational pipeline (S-genotyping). Quality filtering;         samples were mapped into an internal database using bwa         software. Data processing was conducted with R statistical         language and results visualization.

Example 2: Storage of Compositions of P. acnes Strains

The P. acnes strain 6609 was grown in reinforced clostridal medium as liquid culture. After 2 days, the culture was spun down and washed with PBS and then with water as a final wash. Then the culture was resuspended in pure water and aliquoted into samples. A concentrated solution of the additives tested, e.g., peptone or 10×PBS was added to the bacterial suspension. Then the aliquots were stored either at room temperature or at 4° C. In both cases, they were protected from sunlight.

In regular intervals, about every 3-4 days, a dilution series of each sample was taken and the colony-forming unit (CFU) count was determined. The suspension was vortexed and a serial dilution was prepared. To determine the CFU count, aliquots of the dilution were added on an agar plate suitable for growth of P. acnes. 10 μl of an appropriate dilution was added on an agar plate of reinforced clostridial medium. The 10 μl was placed as a drop on top of the plate and run down. This method allows the placement of up to 4 drops on the plate. (e.g., according to http://www.science-projects.com/serdil.htm). Each sample was determined in 4 technical replicates. After 3-4 days of anaerobic incubation, the colony numbers were counted (manually or using the software OpenCFU) and both the average and the standard deviation were determined. Thereby a profile of the colony forming units was monitored over time.

Additionally, bacteria of the skin microbiome were stabilized in a neutral liquid matrix for several weeks at ambient temperature varying between 15-35° C. (FIG. 7). It was demonstrated that Propionibacteria can survive months of storage, exposed to air, at temperatures between 15-35° C. when protected from light. Constant numbers of colony forming units (CFU) from a liquid matrix over months were also recovered (FIG. 6). To assess these numbers, methods that determine the CFU of liquids in a medium-throughput fashion were established as described below. It was shown that compositions were stable for at least 2.5 months.

Next, two vials with liquid bacterial suspension in 0.5% peptone were kept stored for over 6 months. One vial was clear and therefore the contained liquid was exposed to light. The second vial was protected from the light. Both vials were exposed to temperatures between −25° C. to 35° C. with the vast majority of the time being kept at room temperature. After 6 months, live bacteria were recovered from the vial protected from the light, while no live bacteria were recovered from the clear vial in which the bacteria were exposed to light. It is, accordingly, expected that bacterial compositions will be stable for at least three months when protected from light.

Example 3: Additional Components of Bacterial Compositions

Compatibility of compositions comprising one or more live bacterial strains with common cosmetic ingredients was also tested, e.g., Hyaluronic acid, inflammation inhibitors or moisturizers. If a tested common compound is beneficial for acne and is compatible with the compositions comprising one or more live bacterial strains, then it can in some embodiments, be added to the compositions comprising one or more live bacterial strains. However, the main active component within the compositions comprising one or more live bacterial strains is the live bacteria.

The formulations were optimized using in vitro assays. Cultures in plates containing disease microbiomes were treated with different formulations.

The Minimum Inhibitory Concentration Assay assessed the in vitro antimicrobial potency of the test compound. In this assay, the Minimum Inhibitory Concentration (MIC) was the lowest concentration of an agent that completely inhibited visible growth.

4 compounds were tested, which are commonly used in cosmetics or to treat acne for their effect on the growth of different P. acnes strains. The 4 tested compounds were glycolic acid, salicylic acid, lactic acid and hyaluronic acid. The first 3 are commonly used in products to treat acne, while the last one is a commonly used cosmetic compound. Any other compound can be tested the same way.

The test substance was dissolved in water or DMSO (for salicylic acid) and 4 μl of the test substance was added to 196 μl of growth medium resulting in the highest tested compound concentration. Then this concentration was diluted by 2-fold serial titrations, for a total of 11 concentrations and the final vehicle concentration was 2 percent. Following incubation, the test plate was visually examined and each well was scored for growth or complete inhibition of growth; then the MIC was recorded. Each test substance was evaluated in duplicate. Vehicle-control and an active reference agent (clindamycin) were used as blank and positive controls, respectively.

The following three strains were used to assess whether strain specific differences in the tolerance to these compounds could be observed:

-   -   Propionibacterium acnes (ATCC 11827)—A5     -   Propionibacterium acnes (ATCC 29399)     -   Propionibacterium acnes (ATCC 6919)—A1         The final concentrations for each tested compound were:         1. Salicylic acid: 0.3 M in DMSO (through 50× dilution by         medium): 6000, 2000.600, 200, 60, 20, 6, 2, 0.6, 0.2 and 0.06 μM         2. Hyaluronic acid: 5 mg/ml 3 μM (through 50× dilution by         medium): 60, 20, 6, 2, 0.6, 0.2, 0.06, 0.02, 0.006, 0.002 and         0.0006 nM         3. Lactic acid: 100% (13.4M): B, (through 50× dilution by         medium): 2%, 0.6%, 0.2%, 0.06%, 0.02%, 0.006%, 0.002%, 0.0006%,         0.0002%, 0.00006% and 0.00002%         4. Glycolic acid: 9 M in water (through 50× dilution by medium):         180, 60, 18, 6, 1.8, 0.6, 0.18, 0.06, 0.018, 0.006 and 0.0018 mM

For salicylic acid, the MIC was above the maximum water soluble concentrations (6 mM). For hyaluronic acid, the MIC was also above the highest tested concentration of 60 nM. A higher concentration of this compound could not be tested as the high viscosity of the stock solution becomes a limiting factor in the precise handling. These results were valid for all three strains. Therefore, these compounds could be added to a cosmetic formulation containing live bacteria.

For the compounds Glycolic acid and Lactic acid, inhibition of growth was observed at a concentration of 18 mM for the Strains ATCC 11827 and ATCC 6919 and 60 mM for the Strain ATCC 29399. The pattern for lactic acid was similar, with inhibition at 0.2% and 0.6% (FIG. 8). Accordingly, these compounds could be used as additives in lower concentrations. The results indicate strain-specific differences in susceptibility toward environmental changes. Other compounds that can enhance the compositions comprising one or more live bacterial strains, such as emollients, protein stabilizing agents, humectants, astringent agents, pigments, coloring agents, UV-A and UV-B radiation filters, surfactant of a solvent, preservatives, antiseptics, pigments or colorants, can be tested using the same methods.

Example 4: Compositions Comprising Staphylococcus epidermidis (S. epidermidis)

The skin bacteria S. epidermidis naturally produces a lantibiotic, epidermin. A lantibiotic refers to an antibiotic-like peptide that contains the non-protein amino acids lanthionin and 3-methyllanthionine (Schnell et al., 1988). This lantibiotic is highly active against P. acnes. Using random mutagenesis and a high-throughput selection assay, an S. epidermidis strain that has an increased production of epidermin or a production coupled to the presence of P. acnes is selected. The bacteria can mimic the effect of antibiotic therapy against acne as it actively produces antibiotic on the skin.

Additionally, evolutionary experiments are performed to select non-pathogenic P. acnes strains that are more resistant to epidermin. The modified S. epidermidis strain in conjunction with the resistant P. acnes strains are combined in some embodiments in a composition comprising one or more live bacterial strains. Such P. acnes strains have an evolutionary advantage over other P. acnes strains living on the skin because of their resistance towards epidermin, which is produced by the modified S. epidermidis strain. The modified P. acnes strains are likely to replace the other P. acnes strains already living on the skin.

Example 5: Demonstration of a Skin Microbiome Transplantation

Described herein is demonstration of a novel method that can be used to change the bacterial composition of the microbiome of the skin. The skin microbiome of a donor subject was sampled and cultured in the laboratory. Then, this mixture of natural skin bacteria was applied to the skin of a recipient subject. The skin of the recipient subject had previously had its own skin bacteria eradicated by using a standard acne treatment method (e.g., antibiotics or disinfectant).

This method allows the sampling of the skin microbiome of a donor subject to be cultured in the lab and separated into individuals strains. From the individuals strains, a healthy microbiome can be assembled by omitting, exchanging or adding certain strains. This new assembled microbiome can then be reapplied to the same subject or a different subject after the subject's own skin microbiome has been eradicated.

The skin microbiome of a donor subject was transplanted by using a commercial Copan Transystem® swab. Next, the donor subject's skin microbiome was cultured and expanded in the lab and then re-suspended in a neutral carrier liquid (saline solution). The donor subject's skin microbiome was applied to a previously disinfected area of skin on the recipient subject's skin. The skin had been disinfected with sterile gases and ethanol.

The complete microbiome of the recipient subject was sequenced at multiple time points before and after the transplantation using NGS Technologies (Illumina MiSeq). To avoid potential biases of the experiment, the skin area of the recipient subject was divided into four subareas. The first subarea was an untreated control region. The second was disinfected but not treated with bacteria. The third was disinfected and treated with the donor subject's skin microbiome. The fourth was disinfected and treated with a product from AOBiome as a control (AO+ Mist). The treatment was repeated three times and samples of the microbiome were taken in regular intervals, before each new application of bacterial mixture, to track the expected changes in the microbiome.

A 16S library was built to obtain a more generic view of the skin microbiome evolution, and also an SLST allele library to achieve detailed P. acnes strain monitoring. Specific alleles of each strain were amplified to monitor the presence and amount of each microorganism type.

A successful microbiome transplantation was measured from the donor subject to the recipient subject (FIG. 3). A generic 16S profiling transfer was seen from donor to recipient, and specific P. acnes strains were transferred from the donor subject to the recipient subject (FIGS. 3B, 3C). FIG. 3A shows a heatmap displaying the 16S repertoire after transplantation. After several days of application, the recipient subject's 16S profile became closer to the donor subject's 16S profile. FIG. 3B shows P. acnes strains transferred from the donor subject to the recipient subject. In the upper panel, the bar chart shows how some P. acnes strains populated the skin of the recipient. In the lower panel, a phylogenetic tree of the strains were analyzed (based on SLST alleles). FIG. 3C shows a detailed population of the different P. acnes strains in the donor subject, and in the recipient subject. FIG. 3D shows that the recipient subject's skin microbiome became more similar to the donor subject's skin microbiome after 3 days of application. Spearman correlation was used to measure the distance between different microbiomes.

Example 6: Clinical Study

A clinical study was conducted to validate dose response and stability for compositions comprising one or more live bacterial strains. The bacterial composition was tested on 18 healthy individuals over the time period of 11 weeks (which will be continued until a total of 16 weeks is reached). A dose response test to characterize the relationship between the amounts of bacteria applied to the skin and the colonization on the skin was conducted.

Study subjects were split into 3 arms, where each arm received bacterial mixtures consisting of 1 (H1). 2 (H1, A5) or 4 (H1. A5, D1, A1) live bacterial strains of P. acnes. Each mixture was applied in 3 dilutions (undiluted, concentrated 1:100, and 1:1000). Additionally, each subject was applied 3 dilutions of a donor microbiome cultured in the lab; CFU 10⁴/ml, CFU 10⁶/ml and CFU 10⁸/ml. In total, each subject was applied 6 different mixtures/dilutions and a blank formulation.

Bacterial mixtures were applied to the chest and back areas of each subject. These are areas that are rich in sebaceous glands, a natural habitat of P. acnes. Before application of bacterial mixtures, samples of the subject's microbiome were collected using swab and strip method. Application of bacterial mixtures was repeated 3 times, on day 1, day 2 and day 3. Measurement of microbiome samples was repeated on day 1, day 2, day 3 (before bacterial application), day 5, 8, 10, 12, 17, 24, 38, 52, and 66 (samples will also be collected at days 80 and 108). Applications/transplantation were conducted as described in Example 5.

Two different methods of sampling were used. The tested areas were sampled either using epicenter buccal swabs in combination with the extract N′ amp kit from Sigma (Product no. XNAP2) following the procedure described by (Flores et al., 2012) which is herein incorporated by reference in its entirety. Alternatively, the 3 S Biokit (Skin surface Technology) was used, which allows sampling of both bacterial populations on the skin and also in the follicle sebaceous glands. The majority of the P. acnes population lives in the sebaceous glands and therefore such a sampling is superior to skin swabs while still being minimally invasive.

The swab samples were processed as described and stored at −20° C. until PCR amplification. After sampling, the strips were stored in 50 ml falcon tubes at −80° C. until further processing. On the day of processing, the samples were thawed in the morning. After reaching room temperature, a disk with 6 mm diameter was cut out of the strip using Harris Uni-Core Punch 6 mm, (WB100082). This disk was put in a 2 ml tube and 80 μl 0.05M NaoH+20 μl water were added. The sample was vortexed and then incubated for 45 min at 60° C., then vortexed again and spun down. After this, the samples were stored at −20° C. until further processing. Before the first amplification of the typing regions, the samples were purified using Serapure beads which were made as described by (Rohland and Reich, 2012). A 1:1 ratio of bead solution volume to the sample volume was used for the DNA purification step. The purified DNA was then used as template in the subsequent PCR.

For PCR amplification, either polymerase provided by Sigma extract N′ amp kit or a Kappa HIFI ready mix (product no. 07-KK2601-02) were used. For the Kappa reaction, the maximum volume of purified DNA template was used (11.5 μl in a 25 μl reaction). The Sigma protocol was not changed.

The amplification protocols were as follows: SLST Kappa Cycling: 3 min @95° C., 35× cycles, 20 s @98° C., 15 s @ 62° C., 30 s @ 72° C., 1 min @72° C., 4° C. (hold). For the amplification of the 16S amplicon, the recommended protocol from Illumina was used.

After amplification, the samples were indexed using the suggested protocol by Illumina and pooled for sequencing on a MiSeq with v3 chemistry yielding 2*300 bp reads

Additionally, skin irritation and sensitivity to bacterial compositions in healthy individuals were evaluated. No skin irritation or sensitivity linked to the application of compositions comprising one or more live bacterial strains was recorded.

Microbiome differences were computed by comparing the vectors that describe the microbiome. Each position of the vector contains a number indicating the number of times that a certain strain was detected. Correlation distance was used to measure differences between different microbiomes.

Results of durability of the microbiome and the dose response are shown in FIG. 15. A strong effect of the different treatments on the composition of the microbiome was observed, which was absent in the control areas treated with the vehicle only. The treatment effects took a few days to alter the microbiome composition. After this initial period, the changes lasted without additional application of bacteria for 2-3 weeks.

An effect of the CFU dose of bacteria applied to the patient was observed. This effect is mostly present in the first 5 days of the experiment and the observed differences disappear in the long term observation. This result proved that the composition of the microbiome can be changed even on the P. acnes strain level. It also showed that a moderate dose dependency exists between the outcome of the microbiome transplantation and the applied CFU. These data also indicated that the skin microbiome has a tendency to revert to its original state after such a transplantation. This was expected due to the fact that bacteria were only transplanted on small areas in this specific study, while these areas were still surrounded by a natural microbiome. It was a surprising outcome of this study that a distinct microbiome can be selectively established on a small part of the skin of a healthy person for 2-3 weeks until it is reverted to its original state by the surrounding microbiome.

Example 7: Administering Compositions Comprising One or More Live Bacterial Strains to a Subject

A subject is identified as being in need of a composition comprising one or more live bacterial strains. In some instances, the composition comprising one or more live bacterial strains is used for the complementary treatment of acne in combination with, or without or following a prior standard of care acne treatment. A clinical study is conducted to evaluate the effect of administering a composition comprising one or more live bacterial strains to subjects with acne.

Initially, a pilot study was conducted. Compositions comprising 3 live bacterial strains (H1, K4 and K1) were tested on 10 subjects in the age range of 14-25 with facial acne vulgaris. The strains were isolated from healthy individuals and selected based on our meta-analysis of the literature. Study subjects were recruited and selected by a dermatologist. Visual evaluation by a dermatologist (lesion count) was done on day 1 to establish a baseline lesion count. Subjects were instructed to use a branded Benzoyl peroxide product for 7 days. At day 7, subjects were visually evaluated by a dermatologist and were instructed to use a composition comprising one or more live bacterial strains for the following 14 days. 2 times a day. At day 21, subjects were visually evaluated by the dermatologist.

According to dermatologist evaluation. 40% of subjects improved at evaluation week 1 (day 7)—at the end of the Benzoyl Peroxide application phase, 50% of subjects improved receiving a composition comprising one or more live bacterial strains at evaluation week 3 (day 21)—at the end of application of bacterial compositions, and 30% of subjects remained the same state (FIG. 9). Additionally, skin irritation was evaluated. 50% of subjects didn't experience any irritation. 30% showed slight irritation and 20% showed medium to high irritation.

Next, a clinical study is conducted in 50-100 subjects, ages 16-25 with mild to moderate acne vulgaris. Subjects are split into two arms where one arm follows the study design of the conducted pilot; e.g., an initial phase of Benzoyl peroxide application (7 days), then a phase of being administered a composition comprising one or more live bacterial strains twice daily (77 days) and then a follow-up phase (28 days) to evaluate relapse efficacy. Subjects in arm two, a control arm based on standard acne treatment or a vehicle, undergo a phase of Benzoyl peroxide treatment (7 days) and then either continue with Benzoyl peroxide or change to vehicle (77 days) with a follow-up phase (28 days).

Subjects are evaluated visually by a dermatologist (lesion count, irritation and sensitivity) and documented by imaging. Samples of microbiome are taken and self-perception evaluation is documented. Evaluations are conducted, e.g., on days 1, 28, 56, 84 and 112.

Example 8: Association of Trans-10, Cis-12 Linoleic Acid Produced by P. acnes with Increased Lipid Production in Sebaceous Glands

Experiments were performed to show that trans-10, cis-12 linoleic acid triggers increased sebum production observed in acne. The model described by Iinuma et al., 2009b was used. Iinuma et al. showed that immortalized cell lines of sebocytes showed the same results as the isolated sebaceous glands (Iinuma et al., 2009b). Therefore, immortalized cell lines were used for the following experiment:

The sebocytes cell culture was stimulated with two samples:

-   -   1. Linoleic acid,     -   2. Trans-10, cis-12 linoleic acid,         Next, a sebocytes cell culture is stimulated with two more         samples:     -   3. Supernatant and fixed cells from a wild type P. acnes strain,         and     -   4. Supernatant and fixed cells from a mutant of the same strain         as in #3 in which the isomerase gene is deleted by genetic         modification.         The following parameters are measured at various time points         after incubation of these cultures using commercially available         kits which are publically available and known in the art:     -   Total triglyceride content     -   Reactive oxygen species     -   Total protein content for normalization (commercial kit)     -   Perform a final RNA-Seq experiment (outsourced to commercial         provider)

Sebocytes Seb E6/E7 were cultured either in full media (Sebomed (Biochrome, product number F8205) supplemented with 10% FBS, Pen/strep and 5 ng/ml of EGF) or serum free media (500 ml of Sebomed media, Pen/strep, 5 ng/ml of EGF, 2.5 ml of Bovine Pituitary extract (Thermo Fischer order no 11568866) and 0.15 μM LA complexed in 1:1 molar ratio with BSA). Cells were detached using Accutase according to the manufacturer's instructions (Capricorn Scientific, product number ACC-1B). After detachment, cells were counted using Tali (Invitrogen) and a concentration of 40,000 cells were seeded per well. Cells were first seeded in full media. After 24 h, the full media was removed and the cells were exposed to different concentrations of cis-9, cis-12 linoleic acid and the trans-10, cis12 conjugated isomer. After 24 h of exposure, the serum free media was removed and full media containing the compounds in the same concentration was added to stimulate proliferation of the sebocytes. After 96 hours, the cell supernatants were analyzed for the presence of the enzyme lactate dehydrogenase (LDH), which indicates cell lysis, using a commercial assay according to the instructions of the manufacturer (Pierce, product number 88954). The cells which were still attached in the wells were assayed for metabolic activity using a commercial XTT assay (Thermo Fischer, product number X-6493).

A low metabolic activity in combination with a high LDH activity in the medium indicates a cytotoxic effect of the tested compound. The results are shown in FIG. 10. A clear dose-dependent cytotoxic effect of the conjugated isomer is visible, while no significant effect of the cis-9, cis 12 linoleic acid is present. All experiments were performed in triplicates.

Based on the known effect of trans-10, cis-12 linoleic acid on proliferating cells, it is reasonable to assume that the cytotoxic effect is caused by reactive oxygen species and ER-stress (Pierre et al., 2013). To test reactive oxygen species a molecular reactive oxygen marker is used such as Cell ROX from Thermo Fisher in combination with FACS analysis to quantify the extent of reactive oxygen species generation in sebocytes after stimulation with trans-10, cis 12 linoleic acid.

Seb E6/E7 cells, which were seeded in 96-well plates and stimulated as described above were then analyzed for the induction lipid production. After 72 h of stimulation, the cells were stained with HCS LipidTOX deep red neutral lipid stain from Thermo Fisher (product no. H34477) according to the manufacturer's instructions. A final dilution of 1:450 of HCS LipidTOX dye in PBS was used for the staining. The amount of fluorescence was then evaluated using an inverted fluorescence microscope. In one approach, a complete well was imaged at 5× magnification and the total fluorescence in the image was quantified. Each condition was analyzed in triplicates and the results are shown in FIG. 11. A clear dose-dependent induction of lipid production was seen. The magnitude was equal to that of cis-9, cis 12 linoleic acid, which is usually used as a control inducer for lipogenesis in sebocytes.

Alternatively, the fluorescent signal of individual cells, which were randomly selected from a higher magnification images, were quantified. 10 cells per image and 3 wells per condition were quantified. The average fluorescence intensity is shown in FIG. 12. With both analysis methods, a dose-dependent induction of lipogenesis through trans-10, cis 12 linoleic acid was observed. This result showed surprisingly that not only can cis-9, cis-12 linoleic acid induce lipogenesis in Sebocytes, but also the trans-10, cis-12 isomer. This was an unexpected finding as there is a pronounced different effect in the cytoxcity of the two molecules, indicating different target receptors. The fact that sebum production is regulated by holocrine secretion and the increased rate of cell lysis observed in the LDH assay, indicated surprisingly that trans-10, cis-12 linoleic acid is a regulator of sebum production in vivo.

Additionally, a knockout P. acnes strain is generated which lacks the linoleic acid isomerase gene. For this. P. acnes strain KPA171202 is used, which is the only strain for which a successful gene knockout has been described. A circular plasmid with 500 bp homology regions flanking an Erythromycin resistance gene is constructed as described in (Sörensen et al., 2010). As a homology region, the regions 500 bp upstream and downstream of linoleic acid isomerase gene KPA171202:PPA1039 are selected. This knockout will allow for the demonstration that the linoleic acid conversion of P. acnes is involved in the pathogenesis of acne vulgaris.

Example 9: Different P. acnes Strains have Different Levels of Linoleic Acid Isomerase Activity or Final Thresholds of Concentration of Trans-10, Cis-12 Linoleic Acid

Experiments were performed to characterize the linoleic acid isomerase activity of different P. acnes strains. The P. acnes strains were grown in a growth medium lacking linoleic acid as described in the art (Rosson et al., 2004). Cis-9, cis-12 linoleic acid was added to the growth medium and then the amount of trans-10, cis-12 linoleic acid isomer formed was determined. To determine the amount of trans-10, cis-12 linoleic acid produced. FAME (Fatty acid methyl esters) and GC (Gas Chromatography) or HPLC (High Pressure Liquid Chromatography) were used. Established methods for distinguishing cis and trans isomers of unsaturated fatty acids are described in Kramer et al., 2004, which is herein incorporated by reference in its entirety.

P. acnes strains A1 and C3 were grown as starter cultures. The samples were spun down and the pellets were re-suspended in PBS. The samples were normalized to an OD of 0.5 in PBS. 500 μl of this PBS suspension was used to start a culture in 15 ml RCM, which was supplemented with 1.7 mM cis-9, cis-12 linoleic acid and 0.17 mM oleic acid. The samples were left without shaking in the incubator at 37° C. and only vortexed before aliquots were taken. 2 ml aliquots were taken every ˜24 h until T₅. All samples were stored at −80° C. until analysis.

Samples were extracted, converted to FAME and then analyzed by GC. The detailed results for the degradation of cis-9, cis-12 linoleic acid and the production of trans-10, cis-12 linoleic acid is shown in FIG. 13. A very rapid decrease of the 9, cis-12 linoleic acid was seen, with most of the degradation occurring in the first 48 h of the experiment. It was also observed that while strain A1 depletes the linoleic acid completely from the medium, the strain C3 surprisingly slows down in degradation of linoleic acid reaching an equilibrium concentration.

Multiple strains were then compared for their ability to degrade 9, cis-12 linoleic acid. For this. 4 strains: A1, H1. D1 and A5 were grown on reinforced clostridial agar plates. The bacteria was then scraped with an inoculation loop and re-suspended in PBS before being normalized and inoculated in RCM with 1.7 mM 9, cis-12 linoleic acid. These samples were incubated at 37° C. with shaking at 200 rpm. The concentration of cis-9, cis-12 linoleic acid was measured 15 h post-inoculation and clear differences were observed between the strains (FIG. 14). This experiment can be repeated for many other strains and serves as an indication of the pathogenicity potential of an individual strain.

Based on information obtained from the above-described experiments, different strains of P. acnes are combined in a mixture, which exhibits a minimized linoleic acid isomerase activity or linoleic acid degradation. This mixture can be used to colonize the skin and alter the sebum production rate.

Example 10: Use of Random Mutagenesis to Generate Strains with One or Multiple Mutations in the Linoleic Acid Isomerase Gene

A pool of P. acnes mutants is generated from a wild type strain by UV or chemical induced random mutagenesis. Individual strains are isolated that have lost their isomerase activity. To obtain these strains, each individual strain can be tested for their activity or multiple strains can be pooled and the isomerase gene can be amplified including upstream regions. Each pool can be sequenced and pools containing a mutant of the isomerase gene can be further split up until the inactive mutants can be efficiently isolated.

Example 11: Definition and Selection of Non-Pathogenic Strains

A meta-analysis of the publicly available data regarding P. acnes strains and their association with acne vulgaris was conducted. Based on the meta-analysis, a list of 13 strains which are nonpathogenic was compiled. The group of non-pathogenic strains are D1/A5/H1/H2/H3/F4/K4/K1/K6/K9/K8/K2/L1. However, because multiple strains populate one host, it is difficult to classify frequently occurring strains as non-pathogenic. This implies that rarely occurring strains are over-represented as non-pathogenic, while very frequently occurring strains might be wrongly classified as pathogenic.

It is reasonable to assume that frequently occurring strains have a fitness advantage over other strains. For a stable colonization of the skin it is desirable to use strains with a higher degree of fitness. The ability of any P. acnes strain to convert or degrade cis-9, cis-12 linoleic acid as described in Example 9 is therefore used as criteria herein. A slow conversion or degradation of cis-9, cis-12 linoleic acid indicates that a strain is non-pathogenic. A high steady state level of cis-9, cis-12 linoleic acid or a low steady state level of trans-10, cis-12 linoleic acid also indicates that a strain is non-pathogenic.

The SLST sequences used to type the P. acnes strains described herein are listed below in Table 1 and correspond to SEQ ID NOs. 1-76.

Primer sequences used to type the bacterial colonies are listed below in Table 2 and correspond to SEQ ID NOs.77-80. Information on primer sequences is also available at http://medbac.dk/slst/pacnes/protocol.

To prepare a bacteria composition without pathogenic bacteria, complete microbiomes are grown on reinforced clostridial agar plates under anaerobic conditions. Furazolidone (2 μg/mL) is added to inhibit S. epidermidis growth. Then, the bacteria are streaked out by classical microbiology methods to obtain single colonies of P. acnes which are of clonal origin. These colonies are then typed by PCR amplifying and Sanger-sequencing the SLST region as described by (Scholz et al., 2014). Then, the bacteria are re-streaked for multiple passages to ensure that the colony is a pure clone. It is then stored as a clonal population in RCM medium with 30% glycerol at −80° C.

TABLE 1  Sequences used to identify P. acnes strains by SLST SEQ P. ID Acnes NO: Strain Sequence  1 A1 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGGACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG  2 A2 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATTCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG  3 A3 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATGGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAATAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTGGAGGATACAGTCGTCC ATCACC3CCCGCCTACATACCCATTACATCAGCATAG  4 A4 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATGGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG  5 A5 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GCCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCACGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCAGTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG  6 A6 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAT  7 A7 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGCCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATTCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG  8 A8 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGCCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG  9 A9 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GCCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATCTTCCACCCTGTCATCATGAAGGCC ACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATTG TCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCCA TCACGCCCGCCTACATACCCATTACATCAGCATAG 10 A10 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GCCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCTACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 11 A11 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GCCGGGAAACAGCACCAGGAAGCCCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 12 A12 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GCCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATATTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 13 A13 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTGGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 14 A14 GTTGCACACCAGGGGGTCAACTTGGCGTTTTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GCCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 15 A15 GTTGCACACGAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GCCGGGAAACAGTACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 16 A16 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GCCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATCCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 17 A17 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCAC1CACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCGGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACFCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 18 A18 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGCCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 19 A19 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCGACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 20 A20 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT TTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 21 A21 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GCCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACAATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 22 A22 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GCCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTGGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 23 A23 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCTCCTT TCTAGTCAACCCAAGAGAGGAGCAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATTCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 24 B1 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAGCAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 25 C1 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCCGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 26 C2 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCATGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 27 C3 GTTGCACACCAGGGGGTCAACTTGGCGTCCTTAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCCATAG 28 C4 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCTGCATAG 29 D1 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAACTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCACGAAGAC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTTGAGGATACAGTCGTCC ATCACGCCCACCTACATACCCATTACATCAGCATAG 30 D2 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAACTCGTCACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAACGCCGCGATATATGTTCCGCCCTGTCATCACGAAGAC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTTGAGGATACAGTCGTCC ATCACGCCCACCTACATACCCATTACATCAGCATAG 31 D3 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAACTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCTTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCACGAAGAC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTTGAGGATACAGTCGTCC ATCACGCCCACCTACATACCCATTACATCAGCATAG 32 E1 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTTAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACCTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGAATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 33 E2 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTTAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGAAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACCTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 34 E3 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTTAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACCTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 35 E4 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTTAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACCTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGAAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 36 E5 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTTAAACTAACAGTTTCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACCTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAC3TAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 37 E6 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTTAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATTCCGCGATATATGTTCCACCCTGTCATCACGAAGGCC ACCACAATCTATCCCAGAACAGCCGGCACCTCACTCACGATGCCCCGATGCTGGATTCCTATTG TCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCCA TCACGCCCGCCTACATACCCATTACATCAGCATAG 38 E7 GTTGCACACCAGAGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTTAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCCTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACCTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 39 E8 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTTAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACGCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCGCCTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 40 E9 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATAGATTTAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACCTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 41 F1 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTATATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAACGCC ACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATTCTGGATTCCTATTG TCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCCA TCACGCCCGCCTACATACCCATTACATCAGCATAG 42 F2 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTATATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAACGCC ACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATTCTGGATTCCTATTG TCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATCGGAGGTTCGATGTATACTCGAGGATACAGTCGTCCA TCACGCCCGCCTACATACCCATTACACCAGCATAG 43 F3 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTATATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAACGCC ACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATTCTGGATTCCTATTG TCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTAAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCCA TCACGCCCGCCTACATACCCATTACATCAGCATAG 44 F4 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAACGCC ACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCGCCGATGCTGGATTCCTATTG TCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATCTCACCTCAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCCA TCACGCCCGCCTACATACCCATTACATCAGCATAG 45 F5 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAACGCC ACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTAGATTCCTATTG TCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCCA TCACGCCCGCCTACATACCCATTACATCAGCATAG 46 F6 GTTACACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAACGCC ACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATTG TCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGAFACACTCGTCCA TCACGCCCGCCTACATACCCATTACATCAGCATAG 47 F7 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCrCGTGACATATCGTCTTTCATrGCGAGAAACATCTTACTTA TGTATATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAACGCC ACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATTCTGGATTCCTATTG TCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCCA TCAAGCCCGCCTACATACCCATTACATCAGCATAG 48 F8 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGAAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAACGCC ACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATTG TCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCCA TCACGCCCGCCTACATACCCATTACATCAGCATAG 49 F9 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAACGCC ACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATTG TCGCCCTTATTAGGGCAAGCGATGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCCA TCACGCCCGCCTACATACCCATTACATCAGCATAG 50 F10 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACACCCCCT TTCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAACGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 51 G1 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGCCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGGGTGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAACGCC ACCACAATCGATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATTG TCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACCC CTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGTCCA TCACGCCCGCCTACATACCCATTACATCAGCATAG 52 H1 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATATCGTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 53 H2 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATATCGTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTCATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 54 H3 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATATCGTCCACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 55 H4 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCTATATCGTCTACCCTTGTCAGACCCGGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 56 H5 GTTGCACACCAGGGGGTCAACTTGGCGTCCTCAGTTCAAAATTGATTCAAACTAACAGTTCCAT GTCGGGAAACAGCACCAGGAAGCTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TGTACATTTCTAAGCCATATCGTCTACCCTTGTCAGACCCAGGACGATGGATGTCACATCCCCTT TCTAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGTTCCACCCTGTCATCACGAAGGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAACAACTCGATCCACC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATATTCGAGGATACAGTCGTCC ATCACGCCCGCCTACATACCCATTACATCAGCATAG 57 K1 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTCTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCCCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 58 K2 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGGTTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCCCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 59 K3 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTTT CCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCCCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 60 K4 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTAACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCCCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 61 K5 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCTCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 62 K6 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTATTTA TACACATTTCTAAGCTATATTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCGCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 63 K7 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGAAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCCCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGTTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 64 K8 ATTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGGTTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCCCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 65 K9 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGGTTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCCCGATGCTGGATTCCTATGGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 66 K10 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTGACATATCATCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTTT CCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCCCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 67 K11 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGGTTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTGACATGTCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCCCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 68 K12 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGGTTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATACTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCCCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 69 K33 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGGTTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTTGTGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACCCACCATGCCCCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 70 K14 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGGTTCAAACTAACGGTTCCGT GTCCCGAAACAGCACCAGAAAACTCATGACATATCGTCTTTCATTGCGAGAAACATCTTACTTA TACACATTTCTAAGCTATATTGTCTACCCCTGTCAGACCCAGGACGATGGGTGTCATATCCCCTT TCCAGTCAACCTAAGAAGGGAGGAAATGCCGCGATATATGTTCCGCCCTGTCATCATGAATGCC ACCACAATCTATCCCGGAACAGCCGTACTTCACGCACCATGCCCCGATGCTGGATTCCTATTGT CGCCCTTATTAGAGCAAGCGGTGCCAGCAGCAGAATATTTCACCTCAGCAACTCGATCCGCTCC TGCCCATTACATGGGTAACATATCCATGGAGGTACGATGTATGCATCGAGGATGCAGTCGTCTA CTATGCCCGCCTACATACCCATTCCATCAGCATAG 71 L1 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT ATCGGGAAACAGCACCAGAAAACTCGGGACATATCGTCTTTCATTGCGAGAAAAATCTTACTTA TGCGCATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGAGTGTCACATCCCCT TTCCAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGCTCCGCCCTGTCATCACGAAAG CCACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTAT TGTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAGCAACTCGATCCGC CCCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGCC CATCACGCCAGCCTACATACCCATTACATCAGCATAG 72 L2 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT ATCGGGAAACAGCACCAGAAAACTCGGGACATATCGTCTTTCATTGCGAGAAAAATCTTACTTA TGCGCATTTCTAAGCTATAGCGTCTACCCTTGCCAGACCCAGGACGATGAGTGTCACATCCCCT TTCCAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGCTCCGCCCTGTCATCACGAAAG CCACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTAT TGTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAGCAACTCGATCCGC CCCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGCC CATCACGCCAGCCTACATACCCATTACATCAGCATAG 73 L3 GTTGCACAGCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT ATCGGGAAACAGCACCAGAAAACTCGGGACATATCGTCTTTCATTGCGAGAAAAATCTTACTTA TGCGCATTTCTAAGCTATATCGTCTACCCTTGCCAGACCCAGGACGATGAGTGTCACATCCCCTT TCCAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGCTCCGCCCTGTCATCACGAAAGC CACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTATT GTCGCCCATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAGCAACTCGATCCGCC CCTGCCCATTACATGGGTAACATATCCATGGAGGTTGGATGTATACTCGAGGATACAGTCGCCC ATCACGCCAGCCTACATACCCATTACATCAGCATAG 74 L4 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGGGACATATCGTCTTTCATTGCGAGAAAAATCTTACTTA TGCGCATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGAGTGTCACATCCCCT TTCCAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGCTCCGCCCTGTCATCACGAAAG CCACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTAT TGTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAGCAACTCGATCCGC CCCTGCCCATTACATGGTTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGCC CATCACGCCAGCCTACATACCCATTACATCAGCATAG 75 L5 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT GTCGGGAAACAGCACCAGAAAACTCGGGACATATCGTCTTTCATTGCGAGAAAAATCTTACTTA TGCGCATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGAGTGTCACATCCCCT TTCCAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGCTCCGCCCTGTCATCACGAAAG CCACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTAT TGTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAGCAACTCGATCCGC CCCTGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGCC CATCACGCCAGCCTACATACCCATTACATCAGCATAG 76 L6 GTTGCACACCAGGGGGTCAACTTGGTGTCCTCAGTTCAAAATTGATTCAAACTAACGGTTCCGT ATCGGGAAACAGCACCAGAAAACTCGGGACATATCGTCTTTCATTGCGAGAAAAATCTTACTTA TGCGCATTTCTAAGCTATAGCGTCTACCCTTGTCAGACCCAGGACGATGAGTGTCACATCCCCT TTCCAGTCAACCTAAGAGAGGAGGAAATGCCGCGATATATGCTCCGCCCTGTCATCACGAAAG CCACCACAATCTATCCCAGAACAGCCGGCACTTCACTCACGATGCCCCGATGCTGGATTCCTAT TGTCGCCCTTATTAGGGCAAGCGGTGCCAGTAGCAGAATATGTCACCTCAGCAACTCGATCCGC CCCCGCCCATTACATGGGTAACATATCCATGGAGGTTCGATGTATACTCGAGGATACAGTCGCC CATCACGCCAGCCTACATACCCATTACATCAGCATAG

TABLE 2 Primer sequences used to type bacterial colonies SEQ ID NO: Description Sequence 77 Forward primer CAGCGGCGCTGCTAAGAACTT 78 Reverse primer CCGGCTGGCAAATGAGGCAT 79 SLST Adapter TCGTCGGCAGCGTCAGATGTGTATAAG FW AGACAGCAGCGGCGCTGCTAAGAACTT 80 SLST Adapter GTCTCGTGGGCTCGGAGATGTGTATAA RV GAGACAGCCGGCTGGCAAATGAGGCAT

Example 12: Composition of a Cosmetic or Pharmaceutical Product

The compositions comprising one or more live bacterial strains is used as a cosmetic or a pharmaceutical product. Such a product includes one or more live P. acnes strains as described above in addition to peptone or another liquid carrying media in which the bacterial composition stays stable. In some embodiments, the composition is a gel including a gelling compound like hydroxyethyl cellulose or similar.

Compositions described herein can modulate features of the skin such as moisture and pH, resulting in enhancing the beauty and appearance of the skin. Some bacterial compositions described herein can modulate the sebum production and lipid content on the skin, which is particularly beneficial in acne-prone skin and elderly skin.

Compositions described herein can increase or decrease the equilibrium concentration of cis-9, cis-12 linoleic acid or its isomers trans-10, cis-12 linoleic acid in the sebum from its naturally occurring concentration on the skin to a higher or lower concentration. Thereby, the product indirectly delivers the respective compound to the cells of the sebaceous glands and follicles.

Compositions described herein can change the degradation rate of cis-9, cis-12 linoleic acid and thereby indirectly deliver cis-9, cis-12 linoleic acid to the cells in the sebaceous glands.

Additionally, compositions described herein may include compounds such as hyaluronic acid or lactic acid or other compounds to enhance the features of the bacterial composition.

A product comprising a composition described herein is delivered in a packaging protected from light and is stored at room temperature. In some forms, the product can be packaged as a two-component composition, wherein the bacterial composition is freeze-dried and is mixed into the carrying media, such as peptone, before use.

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EQUIVALENTS

Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, many equivalents to the specific embodiments of the invention described herein. Such equivalents are intended to be encompassed by the following claims.

All references, including patent documents, disclosed herein are incorporated by reference in their entirety. 

1-48. (canceled)
 49. A method for treating acne, comprising: topically administering a disinfectant or antibiotic to the skin of a subject with acne; and topically administering a composition comprising one or more live bacterial strains to the skin of the subject following administration of the disinfectant or antibiotic, wherein the one or more live bacterial strains are Propionibacterium acnes (P. acnes) bacterial strains that produce a low or negligible level of trans-10, cis-12 linoleic acid or exhibit a slow or negligible conversion or degradation of cis-9, cis-12 linoleic acid in media.
 50. The method according to claim 49, wherein the one or more P. acnes bacterial strains produce the same or lower level of trans-10, cis-12 linoleic acid than a P. acnes C3 bacterial strain, or wherein the one or more P. acnes bacterial strains exhibit the same or slower conversion or degradation of cis-9, cis-12 linoleic acid in media than a P. acnes C3 bacterial strain.
 51. The method according to claim 49, wherein the one or more P. acnes bacterial strains have a low expression and/or activity of linoleic acid isomerase.
 52. The method according to claim 49, wherein the one or more P. acnes bacterial strains have the same or lower expression and/or activity of linoleic acid isomerase than a P. acnes C3 bacterial strain.
 53. The method according to claim 49, wherein the one or more P. acnes bacterial strains express no linoleic acid isomerase.
 54. The method according to claim 49, wherein the one or more P. acnes bacterial strains have no linoleic acid isomerase activity.
 55. The method according to claim 49, wherein the one or more P. acnes bacterial strains comprise a loss-of-function mutation in the linoleic acid isomerase gene.
 56. The method according to claim 49, wherein all of the P. acnes bacterial strains within the composition produce low or negligible levels of trans-10, cis-12 linoleic acid or exhibit a slow or negligible conversion or degradation of cis-9, cis-12 linoleic acid in media.
 57. The method according to claim 49, wherein the composition is in the form of a gel, cream, ointment, lotion, serum, powder, aerosol spray or two-component dispensing system.
 58. The method according to claim 49, wherein the composition further comprises one or more of a buffer, thickener or carrier.
 59. The method according to claim 49, wherein the composition is stable at room temperature for at least three months.
 60. The method according to claim 49, wherein the composition is not naturally occurring.
 61. The method according to claim 49, wherein the composition further comprises peptone.
 62. The method according to claim 49, wherein the subject is a human.
 63. The method according to claim 49, wherein one or more of the live bacterial strains is a component of a skin microbiome.
 64. The method according to claim 49, wherein at least one of the live bacterial strains is resistant to the antibiotic or disinfectant. 